1689944357 NPI number — HARRIS REGIONAL HOSPITAL, INC

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 1689944357 NPI number — HARRIS REGIONAL HOSPITAL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARRIS REGIONAL HOSPITAL, 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:
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:
1689944357
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
98 DOCTORS DR
Provider Second Line Business Mailing Address:
STE 320
Provider Business Mailing Address City Name:
SYLVA
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28779-4501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-631-8913
Provider Business Mailing Address Fax Number:
828-586-7904

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
98 DOCTORS DR
Provider Second Line Business Practice Location Address:
STE 320
Provider Business Practice Location Address City Name:
SYLVA
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28779-4501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-631-8913
Provider Business Practice Location Address Fax Number:
828-586-7904
Provider Enumeration Date:
01/11/2012

Additional Information

Authorized Official

Authorized Official Last Name:
HEATHERLY
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
828-586-7100

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5919213 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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