Basic Information
Provider Information
NPI: 1568875052
EntityType: 2
ReplacementNPI:  
OrganizationName: HENDERSON COUNTY HOSPITAL CORPORATION
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: PARDEE HOSPITALIST ASSOCIATES
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 N JUSTICE ST
Address2:  
City: HENDERSONVILLE
State: NC
PostalCode: 287913410
CountryCode: US
TelephoneNumber: 8286961000
FaxNumber: 8286947654
Practice Location
Address1: 800 N JUSTICE ST
Address2:  
City: HENDERSONVILLE
State: NC
PostalCode: 287913410
CountryCode: US
TelephoneNumber: 8286961000
FaxNumber: 8286947654
Other Information
ProviderEnumerationDate: 06/03/2014
LastUpdateDate: 06/03/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HOUSE
AuthorizedOfficialFirstName: ALAN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 8286961000
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: HENDERSON COUNTY HOSPTIAL CORPORATION DBA PARDEE MEDICAL ASSOCIATES
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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