Healthcare Provider Details

I. General information

NPI: 1720001688
Provider Name (Legal Business Name): HENDERSON COUNTY HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 03/18/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 COLLEGE DR
FLAT ROCK NC
28731-7756
US

IV. Provider business mailing address

114 COLLEGE DR
FLAT ROCK NC
28731-7756
US

V. Phone/Fax

Practice location:
  • Phone: 828-692-1846
  • Fax: 828-692-5431
Mailing address:
  • Phone: 828-692-1846
  • Fax: 828-692-5431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC0201
License Number StateNC

VII. Legacy identifiers

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

# 1
IdentifierHH954058
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerOASIS
# 2
Identifier3427028
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: JAMES KIRBY II
Title or Position: PRESIDENT, CEO
Credential:
Phone: 828-696-1131