Basic Information
| Provider Information | |||||||||
| NPI: | 1447877238 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HENDERSON COUNTY HOSPITAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 27877 | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841270877 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199668279 | ||||||||
| FaxNumber: | 9199668796 | ||||||||
| Practice Location | |||||||||
| Address1: | 45 HENDERSONVILLE HWY | ||||||||
| Address2: | |||||||||
| City: | PISGAH FOREST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287688895 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284358300 | ||||||||
| FaxNumber: | 8284358301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2020 | ||||||||
| LastUpdateDate: | 06/29/2020 | ||||||||
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| AuthorizedOfficialLastName: | BURLESON | ||||||||
| AuthorizedOfficialFirstName: | REGINA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PAYOR ENROLLMENT | ||||||||
| AuthorizedOfficialTelephone: | 8286948350 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HENDERSON COUNTY HOSPITAL CORPORATION | ||||||||
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| NPICertificationDate: | 06/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.