Basic Information
| Provider Information | |||||||||
| NPI: | 1164495255 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CATAWBA VALLEY MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 810 FAIRGROVE CHURCH RD | ||||||||
| Address2: | |||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286029617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283263809 | ||||||||
| FaxNumber: | 8283263371 | ||||||||
| Practice Location | |||||||||
| Address1: | 810 FAIRGROVE CHURCH RD | ||||||||
| Address2: | |||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286029617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283263809 | ||||||||
| FaxNumber: | 8283263371 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2006 | ||||||||
| LastUpdateDate: | 10/01/2021 | ||||||||
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| AuthorizedOfficialLastName: | CREWS | ||||||||
| AuthorizedOfficialFirstName: | KIMBERY | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | VP OF FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 8283263806 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | H0223 | NC | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 235025B000000 | 01 | NC | TRAILBLAZER PIN | OTHER | 8907682 | 05 | NC | MEDICAID | 3400143 | 05 | NC | MEDICAID | 371710600 | 01 | NC | MEDICAID - BLACK LUNG | OTHER | 98 | 01 | NC | BCBS PROVIDER NUMBER | OTHER |