Provider Demographics
NPI:1801823349
Name:DLP FRYE REGIONAL MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:DLP FRYE REGIONAL MEDICAL CENTER LLC
Other - Org Name:FRYE REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7220
Mailing Address - Street 1:330 SEVEN SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5098
Mailing Address - Country:US
Mailing Address - Phone:615-920-7000
Mailing Address - Fax:615-920-8913
Practice Address - Street 1:420 N CENTER ST
Practice Address - Street 2:STE 20
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5046
Practice Address - Country:US
Practice Address - Phone:828-315-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC0700X, 1041C0700X, 133NN1002X, 284300000X
NCH0053282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
00462OtherBCBS OF NORTH CAROLINA
MO019734607Medicaid
340116B000000OtherSECTION 1011
15110OtherMEDCOST
FL902733500Medicaid
CAXHSP32874Medicaid
GA00109634ZMedicaid
NC3400116Medicaid
56-0852342OtherCATHOLIC HEALTH ALLIANCE
MD229525300Medicaid
VA3401162Medicaid
368769590OtherAETNA US HEALTHCARE (NATI
PA01407106Medicaid
0734412OtherCIGNA (US / PUERTO RICO)
00000-95855OtherPACIFICARE OF TEXAS
0340116OtherTENNCARE
NC3405327Medicaid
NC3400116Medicaid