Provider Demographics
NPI:1649600024
Name:MOSES CONE PHYSICIAN SERVICES, INC
Entity Type:Organization
Organization Name:MOSES CONE PHYSICIAN SERVICES, INC
Other - Org Name:ROCKINGHAM UROLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-832-9500
Mailing Address - Street 1:1818 RICHARDSON DR
Mailing Address - Street 2:STE F
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-5451
Mailing Address - Country:US
Mailing Address - Phone:336-342-4791
Mailing Address - Fax:336-634-0790
Practice Address - Street 1:1818 RICHARDSON DR
Practice Address - Street 2:STE F
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-5451
Practice Address - Country:US
Practice Address - Phone:336-342-4791
Practice Address - Fax:336-634-0790
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MOSES H. CONE MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty