Organization
CHARLES A. CANNON, JR. MEMORIAL HOSPITAL, INC
Active
Parent organization
APPALACHIAN REGIONAL HEALTHCARE SYSTEM INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
APPALACHIAN REGIONAL HEALTHCARE SYSTEM INC.
Authorized official
MRS. MARY ETTA LONG RHIA-CPMSM (SR VP MEDICAL STAFF SPECIALIST)
(828) 262-4133
Entity
Organization
Contact information
Practice address
434 HOSPITAL DRIVE, LINVILLE, NC 28646-0787
(828) 737-7004
(828) 262-9159
Mailing address
PO BOX 787, LINVILLE, NC 28646-0787
(828) 737-7004
(828) 262-9159
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07744
BLUE CROSS
—
01
—
4280174
TN MEDICAID GRP PROV NUMB
TN
05
—
8000300
—
NC
Enumeration date
12/14/2006
Last updated
01/15/2025
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