Provider Demographics
NPI:1013918747
Name:CLEVELAND COUNTY HEALTHCARE SYSTEM
Entity Type:Organization
Organization Name:CLEVELAND COUNTY HEALTHCARE SYSTEM
Other - Org Name:CLEVELAND REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:COYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-487-3802
Mailing Address - Street 1:PO BOX 60164
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0164
Mailing Address - Country:US
Mailing Address - Phone:980-487-7427
Mailing Address - Fax:980-487-7416
Practice Address - Street 1:201 E GROVER ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3917
Practice Address - Country:US
Practice Address - Phone:980-487-7427
Practice Address - Fax:980-487-7416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC021TPOtherBCBS PROFEE
SC314352Medicaid
NC00121OtherBCBS
NC260532OtherMEDICARE CRNA
NCNPB320OtherSC MEDICAID PROFEE
NC3400021Medicaid
SC218077Medicaid
NC235034OtherMEDICARE PROFEE
NC8907694Medicaid
NC3400021Medicaid