1508287343 NPI number — THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508287343 NPI number — THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
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:
1508287343
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
920 CHURCH ST N
Provider Second Line Business Mailing Address:
SUITE 255 H
Provider Business Mailing Address City Name:
CONCORD
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28025-2927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-403-2816
Provider Business Mailing Address Fax Number:
704-403-2818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
920 CHURCH ST N
Provider Second Line Business Practice Location Address:
SUITE 255 H
Provider Business Practice Location Address City Name:
CONCORD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28025-2927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-403-2816
Provider Business Practice Location Address Fax Number:
704-403-2818
Provider Enumeration Date:
12/20/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LAYMON
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
F
Authorized Official Title or Position:
SR VICE PRESIDENT
Authorized Official Telephone Number:
704-403-2276

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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