Provider Demographics
NPI:1720001688
Name:HENDERSON COUNTY HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:HENDERSON COUNTY HOSPITAL CORPORATION
Other - Org Name:PARDEE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:828-696-1131
Mailing Address - Street 1:114 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28731-7756
Mailing Address - Country:US
Mailing Address - Phone:828-692-1846
Mailing Address - Fax:828-692-5431
Practice Address - Street 1:114 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:FLAT ROCK
Practice Address - State:NC
Practice Address - Zip Code:28731-7756
Practice Address - Country:US
Practice Address - Phone:828-692-1846
Practice Address - Fax:828-692-5431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0201251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHH954058OtherOASIS
NC3427028Medicaid
NCHH954058OtherOASIS