Provider Demographics
NPI:1275681264
Name:CLEVELAND COUNTY HEALTHCARE SYSTEM
Entity Type:Organization
Organization Name:CLEVELAND COUNTY HEALTHCARE SYSTEM
Other - Org Name:KINGS MOUNTAIN SWING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:COYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-487-3802
Mailing Address - Street 1:201 EAST GROVER STREET
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150
Mailing Address - Country:US
Mailing Address - Phone:704-476-7439
Mailing Address - Fax:704-476-7417
Practice Address - Street 1:706 W KINGS STREET
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086
Practice Address - Country:US
Practice Address - Phone:704-476-7439
Practice Address - Fax:704-476-7417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC34U037Medicare Oscar/Certification