Provider Demographics
NPI:1922426220
Name:CALDWELL MEMORIAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:CALDWELL MEMORIAL HOSPITAL, INC.
Other - Org Name:MCCREARY CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHADOWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-627-8512
Mailing Address - Street 1:212 MULBERRY ST SW
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5414
Mailing Address - Country:US
Mailing Address - Phone:828-759-4960
Mailing Address - Fax:828-759-4961
Practice Address - Street 1:212 MULBERRY ST SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5414
Practice Address - Country:US
Practice Address - Phone:828-759-4960
Practice Address - Fax:828-759-4961
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CALDWELL MEMORIAL HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-03
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty