Provider Demographics
NPI: | 1003168303 |
---|---|
Name: | THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION |
Entity Type: | Organization |
Organization Name: | THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION |
Other - Org Name: | CONE ADOLESCENT CLINIC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT AND CEO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | ROBERT |
Authorized Official - Middle Name: | T |
Authorized Official - Last Name: | RICE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 336-832-9500 |
Mailing Address - Street 1: | 1200 N ELM ST |
Mailing Address - Street 2: | ADMINISTRATIVE SERVICE BUILDING, SUITE 201 |
Mailing Address - City: | GREENSBORO |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27401-1004 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 336-832-9513 |
Mailing Address - Fax: | 336-832-8272 |
Practice Address - Street 1: | 1131C N CHURCH ST |
Practice Address - Street 2: | ROOM 4 |
Practice Address - City: | GREENSBORO |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27401-1007 |
Practice Address - Country: | US |
Practice Address - Phone: | 336-832-7867 |
Practice Address - Fax: | 336-832-7869 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | THE MOSES H. CONE MEMORIAL HOSPITAL |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2012-10-10 |
Last Update Date: | 2012-10-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RA0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Adolescent Medicine | Group - Multi-Specialty |
No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
No | 111NP0017X | Chiropractic Providers | Chiropractor | Pediatric Chiropractor | Group - Multi-Specialty |
No | 122300000X | Dental Providers | Dentist | Group - Multi-Specialty | |
No | 207K00000X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207QA0000X | Allopathic & Osteopathic Physicians | Family Medicine | Adolescent Medicine | Group - Multi-Specialty |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 2080A0000X | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine | Group - Multi-Specialty |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
No | 2086S0120X | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery | Group - Multi-Specialty |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 364SP0807X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Child & Adolescent | Group - Multi-Specialty |