Basic Information
| Provider Information | |||||||||
| NPI: | 1689611220 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CATAWBA VALLEY MEDICAL CENTER | ||||||||
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| OtherOrganizationName: | PET CT SCANNING CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 235 18TH ST SE | ||||||||
| Address2: | |||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286021364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283263809 | ||||||||
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| Practice Location | |||||||||
| Address1: | 235 18TH ST SE | ||||||||
| Address2: | |||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286021364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283263809 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 11/10/2021 | ||||||||
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| AuthorizedOfficialLastName: | CREWS | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | VP OF FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 8283263806 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.