1952326563 NPI number — HILLTOP COMPREHENSIVE CARE, 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 1952326563 NPI number — HILLTOP COMPREHENSIVE CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HILLTOP COMPREHENSIVE CARE, 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:
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:
1952326563
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/14/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 25558
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28229-5558
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-532-0715
Provider Business Mailing Address Fax Number:
704-532-7481

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5500 EXECUTIVE CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28212-8856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-532-0715
Provider Business Practice Location Address Fax Number:
704-532-7481
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HILL
Authorized Official First Name:
ROSLYN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
704-532-0715

Provider Taxonomy Codes

  • Taxonomy code: 322D00000X , 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: 8300670 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8700450 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6603230 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6603531 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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