Healthcare Provider Details

I. General information

NPI: 1649603721
Provider Name (Legal Business Name): MARS HILL UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ATHLETIC ST
MARS HILL NC
28754-9134
US

IV. Provider business mailing address

100 ATHLETIC ST
MARS HILL NC
28754-9134
US

V. Phone/Fax

Practice location:
  • Phone: 866-642-4968
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ALLEN SHELLEY
Title or Position: HEAD ATHLETIC TRAINER
Credential:
Phone: 828-777-0535