COMMUNITY MEMORIAL HOSPITAL (NPI# 1336103738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336103738 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEMORIAL HOSPITAL |
| Practice Address |
1755 N Mecklenburg Avenue South Hill VA 23970-1431 |
| Practice Telephone | 4345845410 |
| Practice Fax Number | 4345845455 |
| Mailing Telephone | 4345845410 |
| Mailing Fax Number | 4345845455 |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2018-01-30 |
| Authorized Official Name | MR. KENNETH LIBBY JR. (VP FINANCE) |
| Authorized Official Telephone | 4345845410 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
Hospitals | ||
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 004900987 | 05 | |
| VA | ANTHEM PROVIDER # | 000055 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336632280 | Community Memorial Hospital | Clinic/Center | 104 S. West Street, Edgerton, OH 43517 | 2018-06-14 |
| 1528208162 | Community Memorial Hospital | Family Medicine | 100 West 4th St, Montrose, MO 64770 | 2009-02-23 |
| 1689842478 | Community Memorial Hospital | Clinic/Center | 122 2nd St. East, Mcclusky, ND 58463-0618 | 2008-02-14 |
| 1598945867 | Community Memorial Hospital | Clinic/Center | 101 Giesler Dr, Osceola, MO 64776-6297 | 2007-11-05 |
| 1730145392 | Community Memorial Hospital | Clinic/Center | 208 Columbus Street, Hicksville, OH 43526 | 2006-04-24 |
| 1780150110 | Community Memorial Hospital | Clinic/Center | 107 Buffalo St, Antwerp, OH 45813-8434 | 2018-10-24 |
| 1164915021 | Community Memorial Hospital | Clinic/Center | 208 Columbus St, Hicksville, OH 43526-1250 | 2018-06-14 |
| 1891288866 | Community Memorial Hospital | Clinic/Center | 422 W River St, Antwerp, OH 45813-8417 | 2018-06-13 |
| 1609303692 | Community Memorial Hospital | Family Medicine | 164 Broad St, Hamilton, NY 13346-9575 | 2017-05-22 |
| 1477080604 | Community Memorial Hospital | Family Medicine | 117 W Main St, Waterville, NY 13480-1165 | 2017-05-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL | 809 Jackson St, Burke, SD 57523-2065 |
| Virginia Business Entities | Community Memorial Hospital | 1755 N Mecklenburg Ave, P. O. Box 90, South Hill, Virginia 23970-4080 |
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL ASSOCIATION | 400 Caldwell St, Staunton, IL 62088-1173 |
| Virginia Business Entities | Community Memorial Hospital Foundation | 1755 N Mecklenburg Ave, South Hill, Virginia 23970-4080 |
| New York State Corporations | COMMUNITY MEMORIAL HOSPITAL FOUNDATION, INC. | 150 Broad St., Hamilton, Ny 13346 |
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL, INC. | 2731 Healthcare Dr, Syracuse, NE 68446-7880 |
| System for Award Management (SAM) Entities | COMMUNITY MEMORIAL HOSPITAL, INCORPORATED | 800 Memorial Dr Ste 1, Spring Valley, MN 55975-1055 |
| Street Address |
1755 N MECKLENBURG AVENUE |
| City | SOUTH HILL |
| State | VA |
| Zip Code | 23970-1431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891014015 | Community Memorial Hospital | Hospitalist | 1755 N Mecklenburg Avenue, South Hill, VA 23970-1431 | 2010-05-27 |
| 1417021288 | Community Memorial Hospital | Medicare Defined Swing Bed Unit | 1755 N Mecklenburg Avenue, South Hill, VA 23970-1431 | 2006-11-20 |
| 1669551545 | Community Memorial Hospital | Home Health | 1755 N Mecklenburg Avenue, South Hill, VA 23970-1431 | 2006-11-03 |
| 1184709586 | Community Memorial Hospital | Hospice Care, Community Based | 1755 N Mecklenburg Avenue, South Hill, VA 23970-1431 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043784606 | Elizabeth Jene Ezell | Dental Hygienist | 604 N. Thomas St., South Hill, VA 23970 | 2019-01-17 |
| 1821576901 | Mackenzie Jean Blackwell | Dental Hygienist | 604 N. Thomas St, South Hill, VA 23970 | 2018-08-01 |
| 1316459357 | Bernita Danica Boyd | Contractor | 436 Theater Rd, South Hill, VA 23970 | 2017-10-31 |
| 1194242909 | More Transport LLC | Non-emergency Medical Transport (VAN) | 651 Clearview Dr, South Hill, VA 23970 | 2017-08-23 |
| 1912423534 | Larry D Warren | Driver | 730 Hite Street, Po Box 896, South Hill, VA 23970 | 2017-08-15 |
| 1902320658 | Lakika Lyshon Hicks | Non-emergency Medical Transport (VAN) | 74 Hudgins Road, South Hill, VA 23970 | 2017-08-02 |
| 1053835561 | Vernice Luevine Lewis | Driver | 11525 Highway One, South Hill, VA 23970 | 2017-07-27 |
| 1407376924 | Building Blocks To Success LLC | Occupational Therapist | 20429 Hwy Forty-seven, South Hill, VA 23970 | 2017-06-26 |
| 1316477136 | Eric Blackwell | Driver | 248 Circle Dr, South Hill, VA 23970 | 2017-06-14 |
| 1619341443 | North View Day Support LLC | Day Training, Developmentally Disabled Services | 359 Saffold Road, South Hill, VA 23970 | 2015-11-17 |
| Find all providers in zip 23970 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538669445 | Virginia Hospital Center Arlington Health System | General Acute Care Hospital | 8100 Boone Blvd Ste 140, Vienna, VA 22182-2665 | 2018-02-16 |
| 1871020651 | Virginia Internal Medicine Specialists LLC | General Acute Care Hospital | 44790 Maynard Sq Ste 320, Ashburn, VA 20147-6514 | 2017-05-11 |
| 1730615816 | Sentara Healthcare | General Acute Care Hospital | 100 Ireland St, Hampton, VA 23663-2150 | 2017-05-10 |
| 1528592573 | New York Presbyterian Hospital-weill Cornell | General Acute Care Hospital | 9644 Sutton Green Ct, Vienna, VA 22181-6105 | 2017-04-17 |
| 1386181733 | Lyle Purnell | General Acute Care Hospital | 100 Emancipation Dr Bldg 146, Hampton, VA 23667-0001 | 2017-01-24 |
| 1700233855 | Debra Hafer | General Acute Care Hospital | 33290 Chincoteague Rd, Wallops Island, VA 23337-2204 | 2016-05-18 |
| 1093161374 | Mawussi Komi | General Acute Care Hospital | 6271 Drew Dr, Va Beach, VA 23464 | 2016-05-05 |
| 1700248796 | Hq Surgical | General Acute Care Hospital | 905 Hathaway Ct, Chesapeake, VA 23322-7622 | 2016-03-28 |
| 1710355649 | Johnston Memorial Hospital, Inc | General Acute Care Hospital | 3175 Linden Dr Ste 3-5, Bristol, VA 24202-5849 | 2015-09-09 |
| 1184092298 | Anita Sites | General Acute Care Hospital | Uva Transplant Center 1300 Jefferson Park Ave Fl 4, Charlottesville, VA 22908-3363 | 2015-09-04 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH HILL |
| Zip Code | 23970 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.