Provider Demographics
NPI:1487612305
Name:NASH MSO, INC.
Entity type:Organization
Organization Name:NASH MSO, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HOOKS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:252-443-8077
Mailing Address - Street 1:550 N WINSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-2231
Mailing Address - Country:US
Mailing Address - Phone:252-443-8030
Mailing Address - Fax:252-443-8397
Practice Address - Street 1:550 N WINSTEAD AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2231
Practice Address - Country:US
Practice Address - Phone:252-443-8030
Practice Address - Fax:252-443-8397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890127XMedicaid
NC0127XOtherBLUE CROSS
NC0127XOtherBLUE CROSS