Organization
PENNINGTON GAP HMA INC
Active
Other names
Lee Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY PARRY ESQ (SR VP AND GENERAL COUNSEL)
(239) 598-3176
Entity
Organization
Contact information
Practice address
WEST MORGAN AVE, PENNINGTON GAP, VA 24277
(276) 546-1440
Mailing address
WEST MORGAN AVE, PO BOX 70, PENNINGTON GAP, VA 24277
(276) 546-1440
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
H1867
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
442170
BLUE CROSS
VA
Enumeration date
06/08/2006
Last updated
08/22/2020
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