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) 598-3167
Entity
Organization
Contact information
Practice address
WEST MORGAN AVENUE, PENNINGTON GAP, VA 24277
(276) 546-1440
Mailing address
WEST MORGAN AVENUE, PENNINGTON GAP, VA 24277
(276) 546-1440
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
442170
BLUE CROSS VA
VA
Enumeration date
06/09/2006
Last updated
08/22/2020
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