Provider Demographics
NPI:1659523314
Name:MISSION HOSPITALS INC
Entity Type:Organization
Organization Name:MISSION HOSPITALS INC
Other - Org Name:WOUND THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:HATHAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-213-0499
Mailing Address - Street 1:PO BOX 602373
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:828-651-6474
Mailing Address - Fax:828-681-1575
Practice Address - Street 1:31 E MEDICAL CT
Practice Address - Street 2:SUITE 2
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-4969
Practice Address - Country:US
Practice Address - Phone:828-652-3595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901180Medicaid
NC0285POtherBCBS
NC5901180Medicaid