Provider Demographics
NPI:1528405412
Name:THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Entity Type:Organization
Organization Name:THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Other - Org Name:CONE HEALTH IMAGING CENTER AT MEDCENTER KERNERSVILLE
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KITZMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-832-7579
Mailing Address - Street 1:1200 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1004
Mailing Address - Country:US
Mailing Address - Phone:336-832-7579
Mailing Address - Fax:336-832-7705
Practice Address - Street 1:1635 NC HIGHWAY 66 S
Practice Address - Street 2:SUITE 110
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3854
Practice Address - Country:US
Practice Address - Phone:336-993-5328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography