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General NPI Number Information
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NPI Number | 1790740447
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Entity Type | Organization
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Legal Business Name | MMH-COR ENTERPRISES IV LLC
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 5 VANDERBILT PARK DR
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City | ASHEVILLE
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State | NC
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Zip | 28803-1700
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Country | US
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Telephone | 828-274-6000
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Fax | 828-277-6350
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Provider Business Mailing Address
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Address Line | 5 VANDERBILT PARK DR
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City | ASHEVILLE
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State | NC
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Zip | 28803-1700
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Country | US
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Telephone | 828-274-6000
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Fax | 828-277-6350
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Authorized Official
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Title or Position | CEO
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Name | THOMAS A TALLEY
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Credential |
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Telephone | 828-274-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 38785
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License Number State | NC
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