1487841250 NPI number — CRAWLEY MEMORIAL HOSPITAL INC.

Table of content: MR. DOUGLAS JAMES DESZELL CRNA (NPI 1407828858)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487841250 NPI number — CRAWLEY MEMORIAL HOSPITAL INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CRAWLEY MEMORIAL 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:
1487841250
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
315 WEST COLLEGE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOILING SPRINGS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-476-7439
Provider Business Mailing Address Fax Number:
704-476-7417

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
315 WEST COLLEGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOILING SPRINGS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-476-7439
Provider Business Practice Location Address Fax Number:
704-476-7417
Provider Enumeration Date:
09/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HUDGINS
Authorized Official First Name:
JENNIE
Authorized Official Middle Name:
DELORES
Authorized Official Title or Position:
LTC/ACUTE BILLING SUPERVISOR
Authorized Official Telephone Number:
704-476-7439

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3405540 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com