Organization
CHARLES A. CANNON, JR. MEMORIAL HOSPITAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ETTA LONG RHIA-CPMSM (SR VP MEDICAL STAFF SERVICES)
(828) 262-4133
Entity
Organization
Contact information
Practice address
434 HOSPITAL DRIVE, LINVILLE, NC 28646-0787
(828) 262-9154
(828) 262-9159
Mailing address
PO BOX 787, LINVILLE, NC 28646-0787
(828) 262-9154
(828) 262-9159
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0094980
BLUECARE
NC
01
—
019MG
BLUE CROSS OF NC
—
05
—
8907744
—
NC
Enumeration date
12/13/2006
Last updated
01/15/2025
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