Provider Demographics
NPI:1528512670
Name:HENDERSON COUNTY HOSPITAL CORPORATION
Entity type:Organization
Organization Name:HENDERSON COUNTY HOSPITAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-694-7696
Mailing Address - Street 1:709 N JUSTICE ST STE A
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3455
Mailing Address - Country:US
Mailing Address - Phone:828-697-7377
Mailing Address - Fax:828-697-7380
Practice Address - Street 1:709 N JUSTICE ST
Practice Address - Street 2:SUITE A
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3454
Practice Address - Country:US
Practice Address - Phone:828-697-7377
Practice Address - Fax:828-697-7380
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENDERSON COUNTY HOSPITAL CORPORATION DBA PARDEE MEDICAL ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-06
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2351975Medicare PIN