Provider Demographics
NPI:1568673036
Name:MURPHY MEDICAL CENTER
Entity Type:Organization
Organization Name:MURPHY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-778-4712
Mailing Address - Street 1:4130 E US HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-6845
Mailing Address - Country:US
Mailing Address - Phone:828-837-8161
Mailing Address - Fax:
Practice Address - Street 1:4130 E US HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6845
Practice Address - Country:US
Practice Address - Phone:828-837-8161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MURPHY MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36773336C0003X, 3336I0012X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3416176Medicaid
NC3766OtherPHARMACY PERMIT NUMBER
NC3400160Medicaid
NC3438860OtherPHARMACY NCPDP
NC205112Medicaid
NC205112Medicaid
NCAM8443676OtherPHARMACY DEA
NC340160Medicare Oscar/Certification