Healthcare Provider Details

I. General information

NPI: 1891134086
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: 06/20/2013
Last Update Date: 01/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2630 WILLARD DAIRY RD SUITE B
HIGH POINT NC
27265-8351
US

IV. Provider business mailing address

2630 WILLARD DAIRY RD SUITE B
HIGH POINT NC
27265-8351
US

V. Phone/Fax

Practice location:
  • Phone: 336-884-3838
  • Fax: 336-884-3840
Mailing address:
  • Phone: 336-884-3838
  • Fax: 336-884-3840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number11157
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number11157
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number11157
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number11157
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number11157
License Number StateNC

VIII. Authorized Official

Name: MR. ROBERT TIMOTHY RICE
Title or Position: CEO/PRESIDENT
Credential:
Phone: 336-832-9500