Healthcare Provider Details

I. General information

NPI: 1437307006
Provider Name (Legal Business Name): ANESTHESIA CARE OF HENDERSON PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

566 RUIN CREEK RD
HENDERSON NC
27536-2927
US

IV. Provider business mailing address

4194 MENDENHALL OAKS PKWY STE 160
HIGH POINT NC
27265-8034
US

V. Phone/Fax

Practice location:
  • Phone: 252-438-4143
  • Fax: 252-436-1114
Mailing address:
  • Phone: 336-899-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALAN DALE HILLIARD
Title or Position: CFO
Credential:
Phone: 336-899-1410