Provider Demographics
NPI:1104232685
Name:CHEROKEE INDIAN HOSPITAL AUTHORITY
Entity type:Organization
Organization Name:CHEROKEE INDIAN HOSPITAL AUTHORITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-497-9163
Mailing Address - Street 1:1 HOSPITAL ROAD
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:NC
Mailing Address - Zip Code:28719-0000
Mailing Address - Country:US
Mailing Address - Phone:828-497-9163
Mailing Address - Fax:828-497-1723
Practice Address - Street 1:1 HOSPITAL ROAD
Practice Address - Street 2:CALLER BOX C-268
Practice Address - City:CHEROKEE
Practice Address - State:NC
Practice Address - Zip Code:28719-0000
Practice Address - Country:US
Practice Address - Phone:828-497-9163
Practice Address - Fax:828-497-1723
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHEROKEE INDIAN HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-07
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8125122300000X
122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty