MEDICARE: CALDWELL MEMORIAL HOSPITAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RS0012X	Sleep Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1184174542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALDWELL MEMORIAL HOSPITAL, INC.

Provider Business Mailing Address
First Line	:	321 MULBERRY ST SW
Second Line	:	MEDICAL STAFF SERVICES
City	:	LENOIR
State	:	NC
Zip	:	28645-5720
Country	:	US
Telephone Number	:	828-757-5965
Fax Number	:	828-757-5104

Provider Business Practice Location Address
First Line	:	270 PINE MOUNTAIN RD
Second Line	:	SUITE 5
City	:	HUDSON
State	:	NC
Zip	:	28638-2605
Country	:	US
Telephone Number	:	828-757-8206
Fax Number	:	828-757-8283

Authorized Official
Title or Position	:	CFO
Name	:	KAREN SHADOWENS
Credential	:
Telephone Number	:	828-757-5100

Provider Enumeration Date	:	10/10/2016
Last Update Date	:	01/17/2025

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