1225563760 NPI number — HENDERSON COUNTY HOSPITAL CORPORATION

Table of content: (NPI 1225563760)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225563760 NPI number — HENDERSON COUNTY HOSPITAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HENDERSON COUNTY HOSPITAL 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:
Provider Other Organization Name Type Code:
6
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:
1225563760
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/21/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 27877
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84127-0877
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-694-8350
Provider Business Mailing Address Fax Number:
828-694-7654

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2695 HENDERSONVILLE RD
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
ARDEN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28704-8576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-694-8420
Provider Business Practice Location Address Fax Number:
828-694-8421
Provider Enumeration Date:
04/21/2017

Additional Information

Authorized Official

Authorized Official Last Name:
KIRBY
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
828-694-8350

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0185X . This is a "BCBS NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: CF8423 . This is a "RR MEDICARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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