Healthcare Provider Details

I. General information

NPI: 1013265909
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: 08/27/2012
Last Update Date: 10/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509-E NORTH ELAM AVENUE 3RD FLOOR
GREENSBORO NC
27403-1129
US

IV. Provider business mailing address

PO BOX 405633
ATLANTA GA
30384-5633
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-1970
  • Fax: 336-832-1988
Mailing address:
  • Phone: 888-333-1348
  • Fax: 708-342-2517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID LAWRENCE KITZMILLER
Title or Position: ASSISTANT TREASURER
Credential:
Phone: 336-832-7579