MEDICARE: HOT SPRINGS HEALTH PROGRAM, 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	261QF0400X	Federally Qualified Health Center (FQHC)

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CA4200	OTHER		RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	01801	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1376510875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOT SPRINGS HEALTH PROGRAM, INC.

Provider Business Mailing Address
First Line	:	PO BOX 69
Second Line	:
City	:	MARSHALL
State	:	NC
Zip	:	28753-0069
Country	:	US
Telephone Number	:	828-649-0800
Fax Number	:	828-649-3786

Provider Business Practice Location Address
First Line	:	66 NW US 25/70 HWY
Second Line	:
City	:	HOT SPRINGS
State	:	NC
Zip	:	28743-9642
Country	:	US
Telephone Number	:	828-622-3245
Fax Number	:	828-622-7446

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. TERESA B STROM
Credential	:
Telephone Number	:	828-649-0800

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	07/28/2016

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Directions to “HOT SPRINGS HEALTH PROGRAM, INC. ” Practice Location

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