Organization
SOUTHSIDE COMMUNITY HOSPITAL, INC.
Active
Other names
Southside Community Hospital, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG DAVENPORT (CFO)
(434) 200-4708
Entity
Organization
Contact information
Practice address
800 OAK ST, FARMVILLE, VA 23901-1199
(434) 315-2740
(434) 315-2741
Mailing address
800 OAK ST, FARMVILLE, VA 23901-1199
(434) 315-2740
(434) 315-2741
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
0201001262
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140792
PK
—
Enumeration date
06/18/2013
Last updated
03/30/2021
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