Provider Demographics
NPI:1487841250
Name:CRAWLEY MEMORIAL HOSPITAL INC.
Entity Type:Organization
Organization Name:CRAWLEY MEMORIAL HOSPITAL INC.
Other - Org Name:CMH SKILLED UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LTC/ACUTE BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIE
Authorized Official - Middle Name:DELORES
Authorized Official - Last Name:HUDGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-476-7439
Mailing Address - Street 1:315 WEST COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28107
Mailing Address - Country:US
Mailing Address - Phone:704-476-7439
Mailing Address - Fax:704-476-7417
Practice Address - Street 1:315 WEST COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28107
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:2007-09-26
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3405540Medicaid
345540Medicare Oscar/Certification