Healthcare Provider Details

I. General information

NPI: 1841339652
Provider Name (Legal Business Name): STANLY MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 YADKIN ST
ALBEMARLE NC
28001-3441
US

IV. Provider business mailing address

301 YADKIN ST
ALBEMARLE NC
28001-3441
US

V. Phone/Fax

Practice location:
  • Phone: 704-984-4316
  • Fax: 704-984-4276
Mailing address:
  • Phone: 704-984-4316
  • Fax: 704-984-4276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number12916
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AL TAYLOR
Title or Position: CEO AND PRESIDENT
Credential: PHARMD
Phone: 704-984-4347