Provider Demographics
NPI:1023356565
Name:THE MCDOWELL HOSPITAL INC
Entity type:Organization
Organization Name:THE MCDOWELL HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GENTILCORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-213-0048
Mailing Address - Street 1:401 NEBO SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:NEBO
Mailing Address - State:NC
Mailing Address - Zip Code:28761-6924
Mailing Address - Country:US
Mailing Address - Phone:828-659-5791
Mailing Address - Fax:828-652-9994
Practice Address - Street 1:401 NEBO SCHOOL RD
Practice Address - Street 2:
Practice Address - City:NEBO
Practice Address - State:NC
Practice Address - Zip Code:28761-6924
Practice Address - Country:US
Practice Address - Phone:828-659-5791
Practice Address - Fax:828-652-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC114383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2138598OtherPK
NC0595231Medicaid