NPIMap

Organization Active NPI

Southside Community Hospital, Inc.

  • Clinic Pharmacy
  • Farmville, VA
National Provider Identifier
1083053672
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
0201001262 Issued in VA
Legal business name
SOUTHSIDE COMMUNITY HOSPITAL, INC.
Doing business as
Southside Community Hospital, Inc.
Practice address
800 Oak St
Farmville, VA 23901-1199
Phone
(434) 315-2740
Fax
(434) 315-2741
NPI assigned
Jun 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Authorized official

Name
Doug Davenport
Title
Cfo
Phone
(434) 200-4708

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X 0201001262 VA Primary

Addresses

Primary practice location

800 Oak St
Farmville, VA 23901-1199

Mailing address

800 Oak St
Farmville, VA 23901-1199
Phone (434) 315-2740

Other identifiers 1

IdentifierTypeStateIssuer
2140792OtherPK

Other names 1

  • Southside Community Hospital, Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
South Central Fam Med C5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1083053672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 OAK ST",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239011199",
            "telephone_number": "434-315-2740",
            "fax_number": "434-315-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 OAK ST",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239011199",
            "telephone_number": "434-315-2740",
            "fax_number": "434-315-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE COMMUNITY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "434-200-4708"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "VA",
            "license": "0201001262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140792",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southside Community Hospital, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southside Community Hospital, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.