Healthcare Provider Details

I. General information

NPI: 1538783915
Provider Name (Legal Business Name): CALDWELL MEMORIAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2020
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 MULBERRY ST SW
LENOIR NC
28645-5722
US

IV. Provider business mailing address

321 MULBERRY ST SW
LENOIR NC
28645-5720
US

V. Phone/Fax

Practice location:
  • Phone: 828-757-5100
  • Fax:
Mailing address:
  • Phone: 828-757-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

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