Organization
DICKENSON COMMUNITY HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE EDWIN HILTON (EVP/CFO)
(423) 302-3467
Entity
Organization
Contact information
Practice address
312 HOSPITAL DR, CLINTWOOD, VA 24228-6786
(276) 926-0300
(276) 926-0329
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(276) 926-0300
(276) 926-0329
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
H1918
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010038146
—
VA
05
—
01601087
—
KY
01
—
102340
ANTHEM BLUE CROSS
VA
01
—
A24228 00
JOHN DEERE
—
Enumeration date
05/12/2006
Last updated
04/16/2024
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