Healthcare Provider Details

I. General information

NPI: 1730776295
Provider Name (Legal Business Name): NOVANT HEALTH NEW HANOVER REGIONAL MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2020
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 S 17TH ST
WILMINGTON NC
28401-7407
US

IV. Provider business mailing address

PO BOX 604267
CHARLOTTE NC
28260-4267
US

V. Phone/Fax

Practice location:
  • Phone: 910-343-7000
  • Fax:
Mailing address:
  • Phone: 336-277-8757
  • Fax: 336-718-8916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ERNEST LEWIS BOVIO JR.
Title or Position: PRESIDENT NOVANT HEALTH COASTAL REG
Credential:
Phone: 910-667-7040