Organization
IMH PROF INFECT DISEASE
Active
Parent organization
IREDELL MEMORIAL HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
IREDELL MEMORIAL HOSPITAL
Authorized official
MR. ED RUSH (PRESIDENT)
(704) 873-5661
Entity
Organization
Contact information
Practice address
557 BROOKDALE DR, STATESVILLE, NC 28677-4107
(704) 873-5661
Mailing address
557 BROOKDALE DR, STATESVILLE, NC 28677-4107
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5906563
—
NC
Enumeration date
06/30/2006
Last updated
08/28/2008
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