Provider Demographics
NPI:1265466452
Name:FLETCHER HOSPITAL INC.
Entity Type:Organization
Organization Name:FLETCHER HOSPITAL INC.
Other - Org Name:PARK RIDGE HEALTH, PARK RIDGE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURROUGHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-681-2102
Mailing Address - Street 1:PO BOX 948117
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30394-8117
Mailing Address - Country:US
Mailing Address - Phone:828-687-5616
Mailing Address - Fax:828-650-8076
Practice Address - Street 1:100 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5272
Practice Address - Country:US
Practice Address - Phone:828-684-8501
Practice Address - Fax:828-687-5298
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLETCHER HOSPITAL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-11
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0019273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC235091GOtherMEDICARE PROFESSIONAL FEE
NC340023OtherUNICARE
NC5070367OtherUNITED
NC6380360OtherAETNA
NC387OtherBLUE CROSS
NC3400023SMedicaid
NC=========001OtherTRICARE
NC235091GOtherMEDICARE PROFESSIONAL FEE
NC5070367OtherUNITED
NC340023OtherUNICARE
NC34S023Medicare ID - Type Unspecified