Provider Demographics
NPI:1730261645
Name:SMYTH COUNTY COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:SMYTH COUNTY COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDY
Authorized Official - Middle Name:P
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:276-782-1240
Mailing Address - Street 1:1209 SNIDER ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-4221
Mailing Address - Country:US
Mailing Address - Phone:276-783-9753
Mailing Address - Fax:276-783-7786
Practice Address - Street 1:1209 SNIDER ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-4221
Practice Address - Country:US
Practice Address - Phone:276-783-9753
Practice Address - Fax:276-783-7786
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMYTH COUNTY COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-19
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA102044OtherANTHEM GROUP
VAC08997Medicare Oscar/Certification