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Organization

COMMUNITY MEMORIAL HEALTHCENTER

Active
Other names
Community Memorial Dialysis
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RONNIE TATUM JR. (VP OF FINANCE, CFO)
(434) 774-2400
Entity
Organization

Contact information

Practice address
125 BUENA VISTA CIR, SOUTH HILL, VA 23970-1431
(434) 774-2400
Mailing address
PO BOX 90, SOUTH HILL, VA 23970-0090

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000055
ANTHEM
VA
05
004900987
VA
Enumeration date
11/20/2006
Last updated
08/31/2022
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