Provider Demographics
NPI: | 1336564863 |
---|---|
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: | PO BOX 405633 |
Mailing Address - Street 2: | |
Mailing Address - City: | ATLANTA |
Mailing Address - State: | GA |
Mailing Address - Zip Code: | 30384-5633 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 336-832-3150 |
Mailing Address - Fax: | 336-832-3151 |
Practice Address - Street 1: | 301 E WENDOVER AVE |
Practice Address - Street 2: | SUITE 400 |
Practice Address - City: | GREENSBORO |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27401-1230 |
Practice Address - Country: | US |
Practice Address - Phone: | 336-832-3150 |
Practice Address - Fax: | 336-832-3151 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | THE MOSES H. CONE MEMORIAL HOSPITAL |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2014-02-20 |
Last Update Date: | 2014-02-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 2080A0000X | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine | Group - Multi-Specialty |
No | 2080P0006X | Allopathic & Osteopathic Physicians | Pediatrics | Developmental - Behavioral Pediatrics | Group - Multi-Specialty |
No | 2080P0008X | Allopathic & Osteopathic Physicians | Pediatrics | Neurodevelopmental Disabilities | Group - Multi-Specialty |
No | 2080P0201X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Allergy/Immunology | Group - Multi-Specialty |
No | 2080P0202X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | Group - Multi-Specialty |
No | 2080P0205X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology | Group - Multi-Specialty |
No | 2080P0208X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Infectious Diseases | Group - Multi-Specialty |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
No | 363LP0200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics | Group - Multi-Specialty |