Healthcare Provider Details

I. General information

NPI: 1962575860
Provider Name (Legal Business Name): DAVIE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 NC HIGHWAY 801 N
BERMUDA RUN NC
27006-7905
US

IV. Provider business mailing address

223 HOSPITAL ST
MOCKSVILLE NC
27028-2038
US

V. Phone/Fax

Practice location:
  • Phone: 336-998-1300
  • Fax:
Mailing address:
  • Phone: 336-702-5500
  • Fax: 336-702-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC1029
License Number StateNC

VIII. Authorized Official

Name: CHAD J BROWN
Title or Position: PRESIDENT, DAVIE MEDICAL CENTER
Credential:
Phone: 336-713-4944