Healthcare Provider Details

I. General information

NPI: 1982973293
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: 12/16/2011
Last Update Date: 05/07/2018
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 TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number11157
License Number StateNC

VIII. Authorized Official

Name: KIM PORTIS
Title or Position: SITE COORDINATOR/PIC
Credential: PHARM D
Phone: 336-884-3837