Organization · Type 2 NPI

Charles A Cannon JR Memorial Hospital, Inc.

Rural Health Clinic/Center · Banner Elk, NC

NPI number 1073073953 Active

Practice location

150 Park Ave
Banner Elk, NC 28604-6604

Call (828) 898-5178 Map

Fax (828) 262-4103

Mailing address

155 Furman Rd Ste 202
Boone, NC 28607-5049

Specialties and licenses

Taxonomy	Code	License
Rural Health Clinic/Center Primary	261QR1300X	None listed

Rural Health Clinic/Center: Definition to come...

4 other providers at this address

Appalachian Regional Medical AssociatesFamily Medicine Physician Banner Elk, NC NPI 1487891933
Elk River Medical Associates, PAMulti-Specialty Clinic/Center Banner Elk, NC NPI 1093700338
Alfred Douglas Earwood, MDFamily Medicine Physician Banner Elk, NC NPI 1699760959
David Paul Kimmel, MDInternal Medicine Physician Banner Elk, NC NPI 1053306092

NPI record

NPI: 1073073953
Entity type: Organization (Type 2)
Issued: Mar 25, 2019
Last updated: Jan 15, 2025
Status: Active

Other names

<unavail>
Elk River Center for Primary Care · doing business as
Elk River Center for Primary Care · doing business as

Authorized official

Mary Etta Long
Sr. VP Medical Staff Relations
(828) 262-4133

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1073073953

Charles A Cannon JR Memorial Hospital, Inc.'s National Provider Identifier is 1073073953, issued on Mar 25, 2019. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Banner Elk, NC. The record was last updated on Jan 15, 2025.