Provider Demographics
| NPI: | 1003168303 |
|---|---|
| Name: | THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION |
| Entity type: | Organization |
| Organization Name: | THE MOSES H. CONE MEMORIAL HOSPITAL OPERATING CORPORATION |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT AND CEO |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | ROBERT |
| Authorized Official - Middle Name: | T |
| Authorized Official - Last Name: | RICE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 336-832-9500 |
| Mailing Address - Street 1: | 1200 N ELM ST |
| Mailing Address - Street 2: | ADMINISTRATIVE SERVICE BUILDING, SUITE 201 |
| Mailing Address - City: | GREENSBORO |
| Mailing Address - State: | NC |
| Mailing Address - Zip Code: | 27401-1004 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 336-832-9513 |
| Mailing Address - Fax: | 336-832-8272 |
| Practice Address - Street 1: | 1131C N CHURCH ST |
| Practice Address - Street 2: | ROOM 4 |
| Practice Address - City: | GREENSBORO |
| Practice Address - State: | NC |
| Practice Address - Zip Code: | 27401-1007 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 336-832-7867 |
| Practice Address - Fax: | 336-832-7869 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | THE MOSES H. CONE MEMORIAL HOSPITAL |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2012-10-10 |
| Last Update Date: | 2012-10-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207RA0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Adolescent Medicine | Group - Multi-Specialty |
| No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
| No | 111NP0017X | Chiropractic Providers | Chiropractor | Pediatric Chiropractor | Group - Multi-Specialty |
| No | 122300000X | Dental Providers | Dentist | Group - Multi-Specialty | |
| No | 207K00000X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Group - Multi-Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207QA0000X | Allopathic & Osteopathic Physicians | Family Medicine | Adolescent Medicine | Group - Multi-Specialty |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
| No | 2080A0000X | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine | Group - Multi-Specialty |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
| No | 2086S0120X | Allopathic & Osteopathic Physicians | Surgery | Pediatric Surgery | Group - Multi-Specialty |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 364SP0807X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Child & Adolescent | Group - Multi-Specialty |