Healthcare Provider Details

I. General information

NPI: 1487841250
Provider Name (Legal Business Name): CRAWLEY MEMORIAL HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2007
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 WEST COLLEGE AVE
BOILING SPRINGS NC
28107
US

IV. Provider business mailing address

315 WEST COLLEGE AVE
BOILING SPRINGS NC
28107
US

V. Phone/Fax

Practice location:
  • Phone: 704-476-7439
  • Fax: 704-476-7417
Mailing address:
  • Phone: 704-476-7439
  • Fax: 704-476-7417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier3405540
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: MRS. JENNIE DELORES HUDGINS
Title or Position: LTC/ACUTE BILLING SUPERVISOR
Credential:
Phone: 704-476-7439