Provider Demographics
NPI:1013265909
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:CONE HEALTH SICKLE CELL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:KITZMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-832-7579
Mailing Address - Street 1:PO BOX 405633
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-5633
Mailing Address - Country:US
Mailing Address - Phone:888-333-1348
Mailing Address - Fax:708-342-2517
Practice Address - Street 1:509-E NORTH ELAM AVENUE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1129
Practice Address - Country:US
Practice Address - Phone:336-832-1970
Practice Address - Fax:336-832-1988
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MOSES H. CONE MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-27
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5921312Medicaid
NC5921312Medicaid