Healthcare Provider Details

I. General information

NPI: 1477159432
Provider Name (Legal Business Name): CONE HEALTH CONNECTED CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2020
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E WENDOVER AVE
GREENSBORO NC
27401-1229
US

IV. Provider business mailing address

PO BOX 745040
ATLANTA GA
30374-5040
US

V. Phone/Fax

Practice location:
  • Phone: 336-663-5038
  • Fax: 336-663-5367
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SALLY HAMMOND
Title or Position: EXECUTIVE DIRECTOR, OPERATIONS
Credential:
Phone: 336-663-5007