| Organization Name: | CHARLES A. CANNON, JR. MEMORIAL HOSPITAL, INC |
| NPI Number: | 1215098132 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY ETTA LONG (SR VP MEDICAL STAFF SERVICES) |
| Mailing Address: | 434 Hospital Drive Linville |
| State: | NC US |
| Postal Code: | 286460787 |
| Phone Number: | 8282629154 |
| Fax Number: | 8282629159 |
| NPI Enumeration Date: | 12/13/2006 |
| NPI Last Update Date: | 08/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207PE0004X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Emergency Medicine |
| Taxonomy Specialization: | Emergency Medical Services |
| Taxonomy Definition: | An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |