Provider Demographics
NPI:1376673806
Name:MISSION HOSPITALS
Entity Type:Organization
Organization Name:MISSION HOSPITALS
Other - Org Name:MISSION CHILDRENS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEUTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:828-213-1701
Mailing Address - Street 1:MISSION CHILDRENS DENTAL
Mailing Address - Street 2:11 VANDERBILT PARK DRIVE
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1700
Mailing Address - Country:US
Mailing Address - Phone:828-213-1700
Mailing Address - Fax:828-213-1701
Practice Address - Street 1:MISSION CHILDRENS HOSPITAL REUTERS BLDG
Practice Address - Street 2:11 VANDERBILT PARK DRIVE
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1700
Practice Address - Country:US
Practice Address - Phone:828-213-1700
Practice Address - Fax:828-213-1701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC012KFOtherBC BS GROUP
NC890168VMedicaid