1770792137 NPI number — MURPHY MEDICAL CENTER, INC.

Table of content: (NPI 1770792137)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770792137 NPI number — MURPHY MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MURPHY MEDICAL CENTER, INC.
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:
MMC URGENT CARE
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:
1770792137
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 950
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MURPHY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28906-0950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-837-4712
Provider Business Mailing Address Fax Number:
828-837-4808

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
183A LEDFORD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURPHY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28906-6213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-837-4712
Provider Business Practice Location Address Fax Number:
828-837-4808
Provider Enumeration Date:
05/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SHAVER
Authorized Official First Name:
MIKE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF REIMBURSEMENT
Authorized Official Telephone Number:
423-778-4712

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X , with the licence number:  HO239 , 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: 1770792137 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 013E4 . This is a "BCBS OF NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com