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General NPI Number Information
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NPI Number | 1982004289
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Entity Type | Organization
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Legal Business Name | THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 201 E WENDOVER AVE
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City | GREENSBORO
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State | NC
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Zip | 27401-1205
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Country | US
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Telephone | 336-832-3630
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Fax | 336-832-3632
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Provider Business Mailing Address
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Address Line | 201 E WENDOVER AVE
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City | GREENSBORO
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State | NC
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Zip | 27401-1205
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Country | US
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Telephone | 336-832-3630
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Fax | 336-832-3632
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | COURTNEY BLACKWELL ISOM
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Credential | PHARMD
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Telephone | 336-832-3631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 12080
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License Number State | NC
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