Provider Demographics
NPI:1407879380
Name:HENDERSON COUNTY HOSPITAL CORP
Entity Type:Organization
Organization Name:HENDERSON COUNTY HOSPITAL CORP
Other - Org Name:PARDEE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-696-1000
Mailing Address - Street 1:104 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28731-7756
Mailing Address - Country:US
Mailing Address - Phone:828-693-8600
Mailing Address - Fax:
Practice Address - Street 1:104 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:FLAT ROCK
Practice Address - State:NC
Practice Address - Zip Code:28731-7756
Practice Address - Country:US
Practice Address - Phone:828-693-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0586313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3405493Medicaid
NC3405493Medicaid