Provider Demographics
NPI:1851596860
Name:MOREHEAD MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:MOREHEAD MEMORIAL HOSPITAL
Other - Org Name:NEUROLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GROUP PRACTICE MANAGER CBO
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-623-9711
Mailing Address - Street 1:518 S VAN BUREN RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5033
Mailing Address - Country:US
Mailing Address - Phone:336-623-9532
Mailing Address - Fax:336-623-9607
Practice Address - Street 1:518 S VAN BUREN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5033
Practice Address - Country:US
Practice Address - Phone:336-623-9532
Practice Address - Fax:336-623-9607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC99016232084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC235082EMedicare PIN