Provider Demographics
NPI:1649277732
Name:MSJHS AND CCP JOINT DEVELOPMENT COMPANY
Entity type:Organization
Organization Name:MSJHS AND CCP JOINT DEVELOPMENT COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DESOTELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-213-5408
Mailing Address - Street 1:428 BILTMORE AVENUE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4502
Mailing Address - Country:US
Mailing Address - Phone:828-213-5400
Mailing Address - Fax:828-213-5410
Practice Address - Street 1:428 BILTMORE AVENUE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4502
Practice Address - Country:US
Practice Address - Phone:828-213-5400
Practice Address - Fax:828-213-5410
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MSJHS AND CCP JOINT DEVELOPMENT COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-05
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0279282N00000X, 282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC342017Medicare PIN