1659300838 NPI number — PRESBYTERIAN ORTHOPAEDIC HOSPITAL

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659300838 NPI number — PRESBYTERIAN ORTHOPAEDIC HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRESBYTERIAN ORTHOPAEDIC HOSPITAL
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:
PRESBYTERIAN REHABILITATION CENTER AT YMCA
Provider Other Organization Name Type Code:
3
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:
1659300838
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2085 FRONTIS PLAZA BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINSTON SALEM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27103-5614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-277-7226
Provider Business Mailing Address Fax Number:
336-277-9795

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 E MOREHEAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28202-2610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-716-6181
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HARGETT
Authorized Official First Name:
FRED
Authorized Official Middle Name:
M
Authorized Official Title or Position:
EVP/CFO
Authorized Official Telephone Number:
704-384-5184

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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