Provider Demographics
NPI:1376510875
Name:HOT SPRINGS HEALTH PROGRAM, INC.
Entity Type:Organization
Organization Name:HOT SPRINGS HEALTH PROGRAM, INC.
Other - Org Name:HOT SPRINGS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:B
Authorized Official - Last Name:STROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-649-0800
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-0069
Mailing Address - Country:US
Mailing Address - Phone:828-649-0800
Mailing Address - Fax:828-649-3786
Practice Address - Street 1:66 NW US 25/70 HWY
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28743-9642
Practice Address - Country:US
Practice Address - Phone:828-622-3245
Practice Address - Fax:828-622-7446
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOT SPRINGS HEALTH PROGRAM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-02
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1376510875Medicaid
CA4200OtherRAIL ROAD MEDICARE
NC01801OtherBCBS
NC1376510875Medicaid
NC01801OtherBCBS
NC2580362Medicare PIN