Provider Demographics
NPI:1902836943
Name:DLP CENTRAL CAROLINA MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:DLP CENTRAL CAROLINA MEDICAL CENTER LLC
Other - Org Name:CENTRAL CAROLINA HOSPITAL
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 1:1135 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4162
Practice Address - Country:US
Practice Address - Phone:919-774-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0243282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
00306OtherBCBS OF NORTH CAROLINA-HO
NC3406692Medicaid
198831600OtherACS OWCP US TREASURY
340020B000000OtherSECTION 1011
NC8907710Medicaid
0720FOtherBCBS OF NORTH CAROLINA-AM
15120OtherCOVENTRY HEALTH CARE GEOR
6895400OtherUS DEPT OF LABOR BLACK LU
NC3400020Medicaid
598692510OtherAETNA US HEALTHCARE (NATI
NC3406692Medicaid