Healthcare Provider Details

I. General information

NPI: 1134718224
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: 01/13/2021
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2523 DELANEY AVE
WILMINGTON NC
28403-6003
US

IV. Provider business mailing address

101 N CHERRY ST STE 600
WINSTON SALEM NC
27101-4013
US

V. Phone/Fax

Practice location:
  • Phone: 910-772-9202
  • Fax: 910-772-9452
Mailing address:
  • Phone: 336-277-1604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JON KEVIN GRIFFIN
Title or Position: SVP FINANCIAL PLAN AND ANALYSIS
Credential:
Phone: 704-384-4182