1235292582 NPI number — FRYE REGIONAL MEDICAL CENTER

Table of content: (NPI 1235292582)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235292582 NPI number — FRYE REGIONAL MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRYE REGIONAL MEDICAL CENTER
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:
1235292582
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2310 3RD ST NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28601-1406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-324-0030
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FRYE REGIONAL MEDICAL CENTER
Provider Second Line Business Practice Location Address:
420 N. CENTER STREET
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-315-5688
Provider Business Practice Location Address Fax Number:
828-315-3491
Provider Enumeration Date:
12/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
POWELL
Authorized Official First Name:
WANDA
Authorized Official Middle Name:
JEAN
Authorized Official Title or Position:
NEONATAL NURSE PRATITIONER
Authorized Official Telephone Number:
828-315-5688

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  65278 , 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: 65278 . This is a "NNP #" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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