Basic Information
| Provider Information | |||||||||
| NPI: | 1255455705 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MCDOWELL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 730 | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287520730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286595412 | ||||||||
| FaxNumber: | 8286595382 | ||||||||
| Practice Location | |||||||||
| Address1: | 430 RANKIN DR | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287526568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286595412 | ||||||||
| FaxNumber: | 8286595382 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 06/08/2011 | ||||||||
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| AuthorizedOfficialLastName: | STEWART | ||||||||
| AuthorizedOfficialFirstName: | CLINT | ||||||||
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| AuthorizedOfficialTitleorPosition: | CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 8286595196 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | H0097 | NC | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 3408679 | 05 | NC | MEDICAID |