Organization
CARILION EMERGENCY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE GRISETTI (DIRECTOR OF OPERATIONAL SUPPORT)
(540) 224-5352
Entity
Organization
Contact information
Practice address
1906 BELLEVIEW AVE SE, EMERGENCY DEPT., ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5352
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104471
ANTHEM GROUP #
VA
Enumeration date
05/18/2006
Last updated
05/24/2023
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