# JOHNSTON MEMORIAL HOSPITAL, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JOHNSTON MEMORIAL HOSPITAL, INC
- **Other names:** Johnston Memorial Home Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1730123159
- **Legal business name:** JOHNSTON MEMORIAL HOSPITAL, INC
- **Authorized official:** MARY LYNN KRUTAK (EVP/CFO)
- **Authorized official phone:** (423) 302-3423

## Contact information

- **Practice address:** 312 CUMMINGS ST, ABINGDON, VA 24210-3230
- **Practice address phone:** (276) 525-1227
- **Practice address fax:** (276) 525-1236
- **Mailing address:** 311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
- **Mailing address phone:** (276) 252-1277
- **Mailing address fax:** (276) 525-1236

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | H1864 | VA | Yes |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 02/12/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004973411 | — | VA |
| 01 | — | 114600 | ANTHEM BLUE CROSS | VA |