1932202355 NPI number — SWAIN COUNTY HOSPITAL INC

Table of content: (NPI 1932202355)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932202355 NPI number — SWAIN COUNTY HOSPITAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SWAIN COUNTY 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:
1932202355
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
45 PLATEAU ST
Provider Second Line Business Mailing Address:
SUITE 250
Provider Business Mailing Address City Name:
BRYSON CITY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28713-4517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-488-4205
Provider Business Mailing Address Fax Number:
828-488-4240

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45 PLATEAU STREET
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
BRYSON CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28713-4517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-488-4205
Provider Business Practice Location Address Fax Number:
828-488-4240
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HEATHERLY
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
828-586-7100

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 011VV . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 89011VV , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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