Provider Demographics
NPI:1548640543
Name:HENDERSON COUNTY HOSPITAL CORPORATION DBA PARDEE MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:HENDERSON COUNTY HOSPITAL CORPORATION DBA PARDEE MEDICAL ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-696-1000
Mailing Address - Street 1:727 OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3647
Mailing Address - Country:US
Mailing Address - Phone:828-698-5500
Mailing Address - Fax:
Practice Address - Street 1:727 OAKLAND ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3647
Practice Address - Country:US
Practice Address - Phone:828-698-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENDERSON COUNTY HOSPITAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8930358Medicaid
206135BMedicare PIN
C83657Medicare UPIN