Healthcare Provider Details

I. General information

NPI: 1538239397
Provider Name (Legal Business Name): NEW HANOVER REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 S 17TH ST
WILMINGTON NC
28401-7407
US

IV. Provider business mailing address

2131 S 17TH ST P.O. BOX 9000
WILMINGTON NC
28401-7407
US

V. Phone/Fax

Practice location:
  • Phone: 910-343-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License NumberH0221
License Number StateNC

VIII. Authorized Official

Name: MR. EDWIN J. OLLIE
Title or Position: CFO
Credential:
Phone: 910-343-4699