Healthcare Provider Details

I. General information

NPI: 1396119616
Provider Name (Legal Business Name): CHEROKEE INDIAN HOSPITAL AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2015
Last Update Date: 01/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL ROAD CALLER BOX C-268
CHEROKEE NC
28719-9253
US

IV. Provider business mailing address

1 HOSPITAL ROAD
CHEROKEE NC
28719-9253
US

V. Phone/Fax

Practice location:
  • Phone: 828-497-9163
  • Fax:
Mailing address:
  • Phone: 828-497-9163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN CERI DANDO
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 828-497-9163