Healthcare Provider Details

I. General information

NPI: 1326569856
Provider Name (Legal Business Name): MISSION HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2017
Last Update Date: 08/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

589 PENIEL RD
COLUMBUS NC
28722-9470
US

IV. Provider business mailing address

PO BOX 602811
CHARLOTTE NC
28260-2811
US

V. Phone/Fax

Practice location:
  • Phone: 828-255-7776
  • Fax:
Mailing address:
  • Phone: 828-255-7776
  • Fax: 828-274-5134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: RHONDA MILLER
Title or Position: VP REVENUE CYCLE OPERATIONS
Credential:
Phone: 828-651-4144