Provider Demographics
NPI:1952030652
Name:HENDERSON COUNTY HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:HENDERSON COUNTY HOSPITAL CORPORATION
Other - Org Name:PARDEE BLUEMD-611B FIFTH AVENUE WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SUNDAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-696-1175
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 440
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5491
Mailing Address - Country:US
Mailing Address - Phone:984-974-1190
Mailing Address - Fax:
Practice Address - Street 1:611-B FIFTH AVENUE WEST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739
Practice Address - Country:US
Practice Address - Phone:828-698-3301
Practice Address - Fax:828-698-7133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)