1902836943 NPI number — DLP CENTRAL CAROLINA MEDICAL CENTER LLC

Table of content: (NPI 1902836943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902836943 NPI number — DLP CENTRAL CAROLINA MEDICAL CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DLP CENTRAL CAROLINA MEDICAL CENTER LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902836943
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
330 SEVEN SPRINGS WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-5098
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-920-7000
Provider Business Mailing Address Fax Number:
615-920-8913

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1135 CARTHAGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANFORD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27330-4162
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-774-2100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LAWRENCE
Authorized Official First Name:
CHARLOTTE
Authorized Official Middle Name:
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
615-920-7000

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  H0243 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 598692510 . This is a "AETNA US HEALTHCARE (NATI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6895400 . This is a "US DEPT OF LABOR BLACK LU" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0720F . This is a "BCBS OF NORTH CAROLINA-AM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8907710 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3406692 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 198831600 . This is a "ACS OWCP US TREASURY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 340020B000000 . This is a "SECTION 1011" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3400020 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00306 . This is a "BCBS OF NORTH CAROLINA-HO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 15120 . This is a "COVENTRY HEALTH CARE GEOR" identifier . This identifiers is of the category "OTHER".




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