Healthcare Provider Details

I. General information

NPI: 1356695456
Provider Name (Legal Business Name): CALDWELL MEMORIAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2012
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1814 MORGANTON BLVD SW
LENOIR NC
28645-5337
US

IV. Provider business mailing address

321 MULBERRY ST SW MEDICAL STAFF SERVICES
LENOIR NC
28645-5720
US

V. Phone/Fax

Practice location:
  • Phone: 828-759-6210
  • Fax: 828-759-6179
Mailing address:
  • Phone: 828-757-5965
  • Fax: 828-757-5104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN SHADOWENS
Title or Position: CFO
Credential:
Phone: 336-627-8512