Healthcare Provider Details

I. General information

NPI: 1649277732
Provider Name (Legal Business Name): MSJHS AND CCP JOINT DEVELOPMENT COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 BILTMORE AVENUE 4TH FLOOR
ASHEVILLE NC
28801-4502
US

IV. Provider business mailing address

428 BILTMORE AVENUE 4TH FLOOR
ASHEVILLE NC
28801-4502
US

V. Phone/Fax

Practice location:
  • Phone: 828-213-5400
  • Fax: 828-213-5410
Mailing address:
  • Phone: 828-213-5400
  • Fax: 828-213-5410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License NumberH0279
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH0279
License Number StateNC

VIII. Authorized Official

Name: MR. ROBERT DESOTELLE
Title or Position: CEO
Credential:
Phone: 828-213-5408