Organization
RUSSELL COUNTY MEDICAL CENTER, INC
Active
Other names
Russell County Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MILLER (VP, COMMUNITY HEALTH SYSTEMS)
(888) 373-9600
Entity
Organization
Contact information
Practice address
58 CARROLL STREET, LEBANON, VA 24266
(276) 883-8000
Mailing address
PO BOX 198250, ATLANTA, GA 30384-8250
(276) 883-8000
(276) 889-4336
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
H1892
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007676
BLUE CROSS
VA
05
—
0170863000
—
WV
05
—
1868
—
TN
01
—
3101497
BLUE CARE TN MEDICAID OP
TN
01
—
490002
BLUE CARE TN MEDICAID IP
TN
01
—
A2426600
FEDERAL BLACK LUNG
—
Enumeration date
06/17/2005
Last updated
11/27/2007
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