1679970586 NPI number — THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY

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 1679970586 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:
CAROLINAS HEALTHCARE SYSTEM KINGS MOUNTAIN
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:
1679970586
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/01/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 32861
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:
28232-2861
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-512-7124
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
706 W KING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGS MOUNTAIN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28086-2708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
980-487-7436
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/21/2014

Additional Information

Authorized Official

Authorized Official Last Name:
DEFURIO
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT AND CFO
Authorized Official Telephone Number:
704-355-3304

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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