Basic Information
| Provider Information | |||||||||
| NPI: | 1932208576 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | UNC HOSPITALS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 5221 PARAMOUNT PKWY STE 440 | ||||||||
| Address2: | |||||||||
| City: | MORRISVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275605491 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9849741186 | ||||||||
| FaxNumber: | 9849741311 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 MANNING DR | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9849741000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 03/14/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HADAR | ||||||||
| AuthorizedOfficialFirstName: | JANET | ||||||||
| AuthorizedOfficialMiddleName: | TERESA | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT, UNC HOSPITALS | ||||||||
| AuthorizedOfficialTelephone: | 9849742819 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 03/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416A0800X | H0157 | NC | N | Transportation Services | Ambulance | Air Transport | 282N00000X | H0157 | NC | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 1746894 | 05 | LA | MEDICAID | 409160 | 05 | SC | MEDICAID | 90657300 | 05 | FL | MEDICAID | 9817026 | 05 | VA | MEDICAID | 00155625X | 05 | GA | MEDICAID | 00348 | 01 | NC | BCBSNC OUTPT PROV # | OTHER | 170261000 | 05 | WV | MEDICAID | 340061 | 05 | TN | MEDICAID | 00350 | 01 | NC | BCBSNC INPT PROV # | OTHER | 1666522 | 05 | NY | MEDICAID | 3400061 | 05 | NC | MEDICAID | 414097 | 05 | SC | MEDICAID | 4176405 | 05 | NJ | MEDICAID |