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General NPI Number Information
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NPI Number | 1215986260
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Entity Type | Organization
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Legal Business Name | IREDELL MEMORIAL HOSPITAL INCORPORATED
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 218 OLD MOCKSVILLE RD
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City | STATESVILLE
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State | NC
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Zip | 28625-1930
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Country | US
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Telephone | 704-872-6552
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5789
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City | STATESVILLE
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State | NC
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Zip | 28687-5789
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Country | US
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Telephone | 704-872-6552
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Fax | 704-873-2694
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Authorized Official
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Title or Position | CFO - VICE PRESIDENT
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Name | GARY SMITH
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Credential |
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Telephone | 704-878-4505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC0515
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License Number State | NC
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