1588751788 NPI number — THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION

Table of content: (NPI 1588751788)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588751788 NPI number — THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CONE HEALTH COMMUNITY PHARMACY AT WENDOVER MEDICAL CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588751788
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 E WENDOVER AVE
Provider Second Line Business Mailing Address:
STE 115
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27401-1230
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-272-7255
Provider Business Mailing Address Fax Number:
336-272-9615

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 E WENDOVER AVE
Provider Second Line Business Practice Location Address:
STE 115
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27401-1230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-272-7255
Provider Business Practice Location Address Fax Number:
336-272-9615
Provider Enumeration Date:
10/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CLINE
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PHARMACY OPERATIONS
Authorized Official Telephone Number:
336-832-8108

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 07278 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0417204 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2070638 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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