Provider Demographics
NPI:1962446385
Name:LENOIR MEMORIAL HOSPITAL, INCORPORATED
Entity Type:Organization
Organization Name:LENOIR MEMORIAL HOSPITAL, INCORPORATED
Other - Org Name:UNC LENOIR HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-962-8989
Mailing Address - Street 1:100 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1604
Mailing Address - Country:US
Mailing Address - Phone:252-522-7000
Mailing Address - Fax:252-522-7007
Practice Address - Street 1:100 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28503-1678
Practice Address - Country:US
Practice Address - Phone:252-522-7000
Practice Address - Fax:252-522-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0043282N00000X
282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3400027Medicaid
NC00309OtherBCBS
NC=========OtherTRICARE
NC3400027Medicaid