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General NPI Number Information
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NPI Number | 1417783705
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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 | 09/12/2024
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Last Update Date | 12/06/2024
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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 | 704-873-0281
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 896322
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City | CHARLOTTE
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State | NC
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Zip | 28289-6322
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | IREDELL HEALTH SYSTEM
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Name | EARL RICHARD SAFIN
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Credential |
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Telephone | 704-878-7609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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