Provider Demographics
NPI:1205264884
Name:MISSION HOSPITALS, INC.
Entity type:Organization
Organization Name:MISSION HOSPITALS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HATHAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-213-0499
Mailing Address - Street 1:PO BOX 602732
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2732
Mailing Address - Country:US
Mailing Address - Phone:828-651-7484
Mailing Address - Fax:
Practice Address - Street 1:2100 RIDGEFIELD BLVD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2343
Practice Address - Country:US
Practice Address - Phone:828-670-5665
Practice Address - Fax:828-670-5663
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MISSION HOSPITALS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-17
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2351535Medicare PIN