Provider Demographics
NPI:1053597856
Name:HUGH CHATHAM MEMORIAL HOSPITAL INC
Entity type:Organization
Organization Name:HUGH CHATHAM MEMORIAL HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-527-7216
Mailing Address - Street 1:360 PARKWOOD MEDICAL PARK
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-2444
Mailing Address - Country:US
Mailing Address - Phone:336-527-5960
Mailing Address - Fax:
Practice Address - Street 1:200 JOHNSON RIDGE MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2443
Practice Address - Country:US
Practice Address - Phone:336-526-0040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9700498208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC340097Medicare Oscar/Certification