Provider Demographics
NPI:1740465822
Name:HOSPIMED, PLLC
Entity type:Organization
Organization Name:HOSPIMED, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:G
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-495-3852
Mailing Address - Street 1:5925 TWO PINES TRL
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-8461
Mailing Address - Country:US
Mailing Address - Phone:919-556-2704
Mailing Address - Fax:919-556-2704
Practice Address - Street 1:5925 TWO PINES TRL
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-8461
Practice Address - Country:US
Practice Address - Phone:919-556-2704
Practice Address - Fax:919-556-2704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95-00134174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-54037Medicaid
NCG01969Medicare UPIN
NC2337179Medicare PIN