Healthcare Provider Details

I. General information

NPI: 1861794315
Provider Name (Legal Business Name): CALDWELL MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2010
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 MULBERRY ST SW
LENOIR NC
28645-5720
US

IV. Provider business mailing address

5221 PARAMOUNT PKWY STE 440
MORRISVILLE NC
27560-5491
US

V. Phone/Fax

Practice location:
  • Phone: 828-757-5162
  • Fax: 828-757-6172
Mailing address:
  • Phone: 984-974-1191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number10655
License Number StateNC

VIII. Authorized Official

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