Provider Demographics
NPI:1225563760
Name:HENDERSON COUNTY HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:HENDERSON COUNTY HOSPITAL CORPORATION
Other - Org Name:PARDEE MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-694-8350
Mailing Address - Street 1:PO BOX 27877
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0877
Mailing Address - Country:US
Mailing Address - Phone:828-694-8350
Mailing Address - Fax:828-694-7654
Practice Address - Street 1:2695 HENDERSONVILLE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-8576
Practice Address - Country:US
Practice Address - Phone:828-694-8420
Practice Address - Fax:828-694-8421
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENDERSON COUNTY HOSPITAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0185XOtherBCBS NC
NCCF8423OtherRR MEDICARE
NC0185XOtherBCBS NC