Organization
SOUTHSIDE COMMUNITY HOSPITAL, INC.
Active
Other names
Centra Southside Community Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG DAVENPORT (CFO)
(434) 200-4708
Entity
Organization
Contact information
Practice address
800 OAK ST, FARMVILLE, VA 23901-1199
(434) 392-8811
(434) 315-2463
Mailing address
800 OAK ST, FARMVILLE, VA 23901-1199
(434) 392-8811
(434) 315-2463
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
H1904
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4900901
—
VA
Enumeration date
09/14/2005
Last updated
01/27/2022
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