Basic Information
| Provider Information | |||||||||
| NPI: | 1215977194 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CALDWELL MEMORIAL HOSPITAL, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | WESTPOINTE MEDICAL PRACTICE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 321 MULBERRY ST SW | ||||||||
| Address2: | MEDICAL STAFF SERVICES | ||||||||
| City: | LENOIR | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286455720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287575965 | ||||||||
| FaxNumber: | 8287575104 | ||||||||
| Practice Location | |||||||||
| Address1: | 2651 MORGANTON BLVD SW | ||||||||
| Address2: | |||||||||
| City: | LENOIR | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286458183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287578950 | ||||||||
| FaxNumber: | 8287578968 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 07/29/2015 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
| AuthorizedOfficialMiddleName: | T | ||||||||
| AuthorizedOfficialTitleorPosition: | VP/ COO/CNO | ||||||||
| AuthorizedOfficialTelephone: | 8287575100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | CALDWELL MEMORIAL HOSPITAL, INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RA0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Adolescent Medicine | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 89012TU | 05 | NC | MEDICAID | CK4938 | 01 | NC | RR MEDICARE | OTHER | 012TU | 01 | NC | BCBS | OTHER |