# SOUTHSIDE COMMUNITY HOSPITAL INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710056387
- **Authorized official:** DOUG DAVENPORT (CFO)
- **Authorized official phone:** (434) 200-4708

## Contact information

- **Practice address:** 1705 E. 3RD ST., FARMVILLE, VA 23901-1199
- **Practice address phone:** (434) 315-5000
- **Mailing address:** PO BOX 41000, LYNCHBURG, VA 24506-4100
- **Mailing address phone:** (434) 315-5000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | VA | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 04/25/2025

## 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) | — |