MEDICARE: THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION

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	333600000X	Pharmacy	11157	NC
2	3336C0003X	Community/Retail Pharmacy	11157	NC
3	3336I0012X	Institutional Pharmacy	11157	NC
4	3336S0011X	Specialty Pharmacy	11157	NC
5	332B00000X	Durable Medical Equipment & Medical Supplies	11157	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3459573	OTHER	NC	NCPDP

General Provider Information

NPI Number	:	1891134086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION

Provider Business Mailing Address
First Line	:	2630 WILLARD DAIRY RD
Second Line	:	SUITE B
City	:	HIGH POINT
State	:	NC
Zip	:	27265-8351
Country	:	US
Telephone Number	:	336-884-3838
Fax Number	:	336-884-3840

Provider Business Practice Location Address
First Line	:	2630 WILLARD DAIRY RD
Second Line	:	SUITE B
City	:	HIGH POINT
State	:	NC
Zip	:	27265-8351
Country	:	US
Telephone Number	:	336-884-3838
Fax Number	:	336-884-3840

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MR. ROBERT TIMOTHY RICE
Credential	:
Telephone Number	:	336-832-9500

Provider Enumeration Date	:	06/20/2013
Last Update Date	:	01/23/2014

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1982973293 — THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Practice Location Address:

2630 WILLARD DAIRY RD , SUITE B
HIGH POINT, NC
27265-8351

Practice Phone: 336-884-3838
Practice Fax: 336-884-3840

Directions to “THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION ” Practice Location

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