Healthcare Provider Details

I. General information

NPI: 1487116968
Provider Name (Legal Business Name): THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2019
Last Update Date: 12/10/2019
Certification Date: 12/10/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 ELMSLEY ST STE 101
GREENSBORO NC
27406-7039
US

IV. Provider business mailing address

3711 ELMSLEY ST STE 101
GREENSBORO NC
27406-7039
US

V. Phone/Fax

Practice location:
  • Phone: 336-890-2165
  • Fax: 336-890-2166
Mailing address:
  • Phone: 336-890-2165
  • Fax: 336-890-2166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

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