1629015698 NPI number — RALEIGH GENERAL HOSPITAL LLC

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629015698 NPI number — RALEIGH GENERAL HOSPITAL LLC

Employer Identification Number (EIN):

Provider Organization Name:

RALEIGH GENERAL HOSPITAL LLC

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

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:

1629015698

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

10/05/2022

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

330 SEVEN SPRINGS WAY

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

BRENTWOOD

Provider Business Mailing Address State Name:

TN

Provider Business Mailing Address Postal Code:

37027-5098

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

615-920-7000

Provider Business Mailing Address Fax Number:

615-920-8987

Provider First Line Business Practice Location Address:

1710 HARPER RD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

BECKLEY

Provider Business Practice Location Address State Name:

WV

Provider Business Practice Location Address Postal Code:

25801-3357

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

304-256-4100

Provider Business Practice Location Address Fax Number:

304-256-4009

Provider Enumeration Date:

05/31/2006

Authorized Official Last Name:

LAWRENCE

Authorized Official First Name:

CHARLOTTE

Authorized Official Middle Name:

Authorized Official Title or Position:

SECRETARY

Authorized Official Telephone Number:

502-596-7000

• Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 000324361 . This is a "BLUE CROSS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
• Identifier: 000363129X , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
• Identifier: 01690361 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
• Identifier: 7169380 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
• Identifier: 424655100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 318873 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
• Identifier: 5100070 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
• Identifier: 0001207000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
• Identifier: 009811940 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
• Identifier: 90849500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
• Identifier: 033172100 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
• Identifier: 178430000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
• Identifier: 3025830 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
• Identifier: 00426302 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 30-4759022 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".