Provider Demographics
NPI:1104265271
Name:THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Entity type:Organization
Organization Name:THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-832-9500
Mailing Address - Street 1:515 N ELAM AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1118
Mailing Address - Country:US
Mailing Address - Phone:336-218-5762
Mailing Address - Fax:336-218-5763
Practice Address - Street 1:515 N ELAM AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1118
Practice Address - Country:US
Practice Address - Phone:336-218-5762
Practice Address - Fax:336-218-5763
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THA MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11254333600000X, 3336C0003X, 3336I0012X
NC122543336S0011X
NC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3460007OtherNCPDP