1649214289 NPI number — PRESBYTERIAN REGIONAL HEALTHCARE CORPORATION

Table of content: (NPI 1649214289)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649214289 NPI number — PRESBYTERIAN REGIONAL HEALTHCARE CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRESBYTERIAN REGIONAL HEALTHCARE CORPORATION
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:
1649214289
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:
1900 RANDOLPH RD
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28207-1106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-384-9113
Provider Business Mailing Address Fax Number:
704-316-0508

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1718 E 4TH ST
Provider Second Line Business Practice Location Address:
SUITE 404
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28204-3260
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-384-9437
Provider Business Practice Location Address Fax Number:
704-384-9440
Provider Enumeration Date:
06/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EASTERLING
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VICE PRESIDENT
Authorized Official Telephone Number:
704-384-9113

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com