Healthcare Provider Details

I. General information

NPI: 1598271306
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: 12/18/2017
Last Update Date: 12/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525C PHILLIPS AVE
GREENSBORO NC
27405-5357
US

IV. Provider business mailing address

300 E WENDOVER AVE FL 4
GREENSBORO NC
27401-1229
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-7711
  • Fax: 336-832-7733
Mailing address:
  • Phone: 336-663-5220
  • Fax: 336-663-5366

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: KIELI ASHTON FORBES
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 336-663-5220