Healthcare Provider Details
I. General information
NPI: 1003985375
Provider Name (Legal Business Name): NEW HANOVER REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2006
Last Update Date: 04/04/2008
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
WILMINGTON NC
28401-7407
US
V. Phone/Fax
- Phone: 910-343-7000
- Fax:
- Phone: 910-343-7000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 283X00000X |
| Taxonomy | Rehabilitation Hospital |
| License Number | H0221 |
| License Number State | NC |
VIII. Authorized Official
Name: MR.
EDWIN
J.
OLLIE
Title or Position: CFO
Credential:
Phone: 910-343-4699