Healthcare Provider Details
I. General information
NPI: 1215977194
Provider Name (Legal Business Name): CALDWELL MEMORIAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/07/2006
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2651 MORGANTON BLVD SW
LENOIR NC
28645-8183
US
IV. Provider business mailing address
321 MULBERRY ST SW MEDICAL STAFF SERVICES
LENOIR NC
28645-5720
US
V. Phone/Fax
- Phone: 828-757-8950
- Fax: 828-757-8968
- Phone: 828-757-5965
- Fax: 828-757-5104
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RA0000X |
| Taxonomy | Adolescent Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAREN
SHADOWENS
Title or Position: CFO
Credential:
Phone: 828-757-5100