1225185507 NPI number — HOLLY SPRINGS MEDICAL CENTER, PA

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 1225185507 NPI number — HOLLY SPRINGS MEDICAL CENTER, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOLLY SPRINGS MEDICAL CENTER, PA
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:
1225185507
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 HOLLY SPRINGS ROAD
Provider Second Line Business Mailing Address:
SUITE #100
Provider Business Mailing Address City Name:
HOLLY SPRINGS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27540-6204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-552-5845
Provider Business Mailing Address Fax Number:
919-567-3109

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 HOLLY SPRINGS ROAD
Provider Second Line Business Practice Location Address:
SUITE #100
Provider Business Practice Location Address City Name:
HOLLY SPRINGS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27540-6204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-552-5845
Provider Business Practice Location Address Fax Number:
919-567-3109
Provider Enumeration Date:
01/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STEIMLE
Authorized Official First Name:
PEGGY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
919-552-5845

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 9901648 , 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: 89013P4 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 89127WJ , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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