1265869846 NPI number — THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

Table of content: MS. QUINCY ELIZABETH DAVISSON DIPL.AC., L.AC (NPI 1700230315)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265869846 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:
1265869846
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 19305
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:
28219-9305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-631-0002
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12925 HIGHWAY 601
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
MIDLAND
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28107-9535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-888-3702
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/27/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RISSMILLER
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
Authorized Official Title or Position:
ENTERPRISE EVP
Authorized Official Telephone Number:
704-355-8675

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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