Provider Demographics
NPI:1124018494
Name:CAH ACQUISITION COMPANY 1 LLC
Entity Type:Organization
Organization Name:CAH ACQUISITION COMPANY 1 LLC
Other - Org Name:WASHINGTON COUNTY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:TITUS
Authorized Official - Last Name:AVIGNONE
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:214-502-9624
Mailing Address - Street 1:7920 BELT LINE RD STE 215
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-8155
Mailing Address - Country:US
Mailing Address - Phone:214-502-9624
Mailing Address - Fax:252-793-7740
Practice Address - Street 1:958 US HIGHWAY 64 E
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NC
Practice Address - Zip Code:27962
Practice Address - Country:US
Practice Address - Phone:252-793-4135
Practice Address - Fax:252-793-7740
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAH ACQUISITION COMPANY 1 LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-26
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0006282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3401314Medicaid
NC3401314Medicaid
NC5293724OtherUNITED HEALTHCARE
NC341314Medicare Oscar/Certification
NC3401314Medicaid