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Organization

MOUNTAIN STATES HEALTH ALLIANCE

Active
Other names
Russell County Medical Center Anesthesiology Department
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARVIN H. EICHORN (SENIOR VICE PRESIDENT AND CFO)
(423) 431-1017
Entity
Organization

Contact information

Practice address
58 CARROLL STREET, LEBANON, VA 24266-4510
(276) 883-8000
Mailing address
58 CARROLL STREET, LEBANON, VA 24266-4510
(276) 883-8000

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
H1892
VA

Other

Enumeration date
02/25/2008
Last updated
02/25/2008
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