Provider Demographics
NPI:1932202355
Name:SWAIN COUNTY HOSPITAL INC
Entity type:Organization
Organization Name:SWAIN COUNTY HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HEATHERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-586-7100
Mailing Address - Street 1:45 PLATEAU ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BRYSON CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28713-4517
Mailing Address - Country:US
Mailing Address - Phone:828-488-4205
Mailing Address - Fax:828-488-4240
Practice Address - Street 1:45 PLATEAU STREET
Practice Address - Street 2:SUITE 250
Practice Address - City:BRYSON CITY
Practice Address - State:NC
Practice Address - Zip Code:28713-4517
Practice Address - Country:US
Practice Address - Phone:828-488-4205
Practice Address - Fax:828-488-4240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC011VVOtherBCBS
NC89011VVMedicaid
NC89011VVMedicaid