Healthcare Provider Details

I. General information

NPI: 1578949079
Provider Name (Legal Business Name): CALDWELL MEMORIAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2015
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8439 VALLEY BLVD
BLOWING ROCK NC
28605-9052
US

IV. Provider business mailing address

321 MULBERRY ST SW MEDICAL STAFF SERVICES
LENOIR NC
28645-5720
US

V. Phone/Fax

Practice location:
  • Phone: 828-295-3116
  • Fax: 828-295-4388
Mailing address:
  • Phone: 828-757-5965
  • Fax: 828-757-5104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN SHADOWENS
Title or Position: CFO
Credential:
Phone: 336-627-8512