Basic Information
Provider Information
NPI: 1265774590
EntityType: 2
ReplacementNPI:  
OrganizationName: MOUNTAIN AREA HEALTH EDUCATION CENTER, INC.
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName: MAHEC FAMILY HEALTH CENTER AT NEWBRIDGE
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 119 HENDERSONVILLE RD
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288032868
CountryCode: US
TelephoneNumber: 8282574725
FaxNumber: 8282322953
Practice Location
Address1: 218 ELKWOOD AVE STE 102
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288042212
CountryCode: US
TelephoneNumber: 8282574747
FaxNumber: 8282574763
Other Information
ProviderEnumerationDate: 03/25/2013
LastUpdateDate: 06/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HATHAWAY
AuthorizedOfficialFirstName: WILLIAM
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 8282574400
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: MD
NPICertificationDate: 06/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 
207V00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 
261QF0400X  Y Ambulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)

No ID Information.


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