Healthcare Provider Details
I. General information
NPI: 1386195055
Provider Name (Legal Business Name): MISSION HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2016
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7 VANDERBILT PARK DR
ASHEVILLE NC
28803-1700
US
IV. Provider business mailing address
PO BOX 602373
CHARLOTTE NC
28260-2373
US
V. Phone/Fax
- Phone: 828-213-9090
- Fax: 828-213-9091
- Phone: 828-213-1500
- Fax: 828-651-6570
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
HATHAWAY
Title or Position: CMO
Credential: MD
Phone: 828-213-1111