NPIMap

Organization Active NPI

Mountain States Health Alliance

Doing business as Russell County Medical Center Anesthesiology Department

  • Anesthesiology Physician
  • Lebanon, VA
National Provider Identifier
1073782900
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
H1892 Issued in VA
Legal business name
MOUNTAIN STATES HEALTH ALLIANCE
Doing business as
Russell County Medical Center Anesthesiology Department
Practice address
58 Carroll Street
Lebanon, VA 24266-4510
Phone
(276) 883-8000
NPI assigned
Feb 25, 2008
Last updated
Feb 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Marvin H. Eichorn
Title
Senior Vice President and Cfo
Phone
(423) 431-1017

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X H1892 VA Primary

Addresses

Primary practice location

58 Carroll Street
Lebanon, VA 24266-4510

Mailing address

58 Carroll Street
Lebanon, VA 24266-4510
Phone (276) 883-8000

Other names 1

  • Russell County Medical Center Anesthesiology Department Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203897600000",
    "number": "1073782900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 CARROLL STREET",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242664510",
            "telephone_number": "276-883-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 CARROLL STREET",
            "city": "LEBANON",
            "state": "VA",
            "postal_code": "242664510",
            "telephone_number": "276-883-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATES HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2008-02-25",
        "status": "A",
        "authorized_official_last_name": "EICHORN",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT AND CFO",
        "authorized_official_telephone_number": "423-431-1017",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "H1892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Russell County Medical Center Anesthesiology Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.