Provider Demographics
NPI:1790756591
Name:HAYWOOD REGIONAL MEDICAL CENTER URGENT CARE CENTERS
Entity Type:Organization
Organization Name:HAYWOOD REGIONAL MEDICAL CENTER URGENT CARE CENTERS
Other - Org Name:HRMC UCC
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:STEGALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-452-8390
Mailing Address - Street 1:262 LEROY GEORGE DR
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-7430
Mailing Address - Country:US
Mailing Address - Phone:828-452-8390
Mailing Address - Fax:
Practice Address - Street 1:576 LEROY GEORGE DR
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-7497
Practice Address - Country:US
Practice Address - Phone:828-452-8390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3400025Medicaid
340025Medicare ID - Type Unspecified