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Organization
SOUTHSIDE COMMUNITY HOSPITAL INC.
Active
Organization
SOUTHSIDE COMMUNITY HOSPITAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG DAVENPORT (CFO)
(434) 200-4708
Entity
Organization
Contact information
Practice address
1705 E. 3RD ST., FARMVILLE, VA 23901-1199
(434) 315-5000
Mailing address
PO BOX 41000, LYNCHBURG, VA 24506-4100
(434) 315-5000
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004970551
—
VA
01
—
1520
GENTIVA CARECENTRIX
—
01
—
20066
OPTIMA FAMILY CARE
VA
01
—
59075
CARENET(MEDICAID HMO)
VA
01
—
780021
ANTHEM BCBS
VA
01
—
=========
TRICARE (HEALTHNET FED)
—
Enumeration date
11/07/2006
Last updated
04/25/2025
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