Basic Information
| Provider Information | |||||||||
| NPI: | 1700208733 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MCDOWELL HOSPITAL | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MISSION UROLOGY-BURKE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 602373 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282602373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286516474 | ||||||||
| FaxNumber: | 8286811575 | ||||||||
| Practice Location | |||||||||
| Address1: | 149 W PARKER RD | ||||||||
| Address2: | |||||||||
| City: | MORGANTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286554673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286595777 | ||||||||
| FaxNumber: | 8286597829 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2014 | ||||||||
| LastUpdateDate: | 01/10/2014 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | RHONDA | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | VP REVENUE CYCLE OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 8286516570 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MCDOWELL HOSPITAL | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
No ID Information.