Provider Demographics
NPI:1710484811
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:CHILD ADVOCACY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:P
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-663-5007
Mailing Address - Street 1:201 S GREENE ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-6417
Mailing Address - Country:US
Mailing Address - Phone:336-832-3291
Mailing Address - Fax:336-333-2390
Practice Address - Street 1:201 S GREENE ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-641-7233
Practice Address - Fax:336-641-2320
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MOSES H CONE MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-06
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty