Organization
CHARLES A CANNON JR MEMORIAL HOSPITAL, INC.
Active
Parent organization
APPALACHIAN REGIONAL HEALTHCARE SYSTEM
Organization subpart
Yes
Provider details
NPI number
Legal business name
APPALACHIAN REGIONAL HEALTHCARE SYSTEM
Authorized official
MRS. MARY ETTA LONG (SR VP MEDICAL STAFF RELATIONS)
(828) 261-4133
Entity
Organization
Contact information
Practice address
434 HOSPITAL DRIVE, LINVILLE, NC 28646-0787
(828) 737-7000
(828) 737-7034
Mailing address
PO BOX 787, LINVILLE, NC 28646-0787
(828) 737-7000
(828) 737-7034
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
H0037
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0080C
NC BLUE CROSS SWB PROV #
NC
01
—
152168200
OWCP SWB PROV NUMBER
NC
05
—
3461323
—
NC
01
—
5070877
UNITED HEALTHCARE SWINGBE
NC
Enumeration date
12/04/2006
Last updated
01/15/2025
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