- Enrollment id
- O20070224000104
- Enrollment state
- VA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1912987231
- Multiple npi flag
- N
- Ccn
- 497018
- Associate id
- 4183604259
- Organization name
- CARILION TAZEWELL COMMUNITY HOSPITAL
- Doing business as name
- CARILION HOME CARE SERVICES TAZEWELL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 388 BEN BOLT AVE
- City
- TAZEWELL
- State
- VA
- Zip code
- 246519700