Carilion Healthcare Corporation
Organization Active NPI Rural Health Clinic/Center · Galax, VA
NPI 1477178366 · NPPES record last updated May 25, 2023
Key facts
- NPI
- 1477178366
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- CARILION HEALTHCARE CORPORATION
- Practice address
- 544 E Stuart Dr Ste D
Galax, VA 24333-2231 - Phone
- (276) 236-6136
- NPI assigned
- Jun 16, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- CARILION HEALTHCARE CORPORATION
Authorized official
- Name
- Nicole Grisetti
- Title
- Director of Operational Support
- Phone
- (540) 224-5352
Change of ownership 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Sep 8, 2020 | Change of Ownership |
Carilion Clinic |
National Provider Directory
- Part of
- Carilion Hlthcare Corp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
544 E Stuart Dr Ste D
Galax, VA 24333-2231
Mailing address
213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5372
Other names
- Carilion Clinic Family & Internal Medicine
Other providers in Galax, VA
- Capriccio Elite, LLC
- Carewave Solutions Swva LLC
- Kelly Hill Carico
- Carilion Giles Community Hospital
- Carilion Giles Community Hospital
- Jamie Lynn Carlo-Demovich
- Phyllis Dianne Carpenter
- Carrefour Counseling & Play Therapy LLC
- Neil Thomas Carstens
- Paula Carter
All providers in Galax, VA · Rural Health Clinic/Center in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.