Organization
STATESVILLE HMA, LLC
Active
Other names
Davis Regional Med Center CRNA
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY PARRY ESQ (SR VP AND GENERAL COUNSEL)
(239) 598-3176
Entity
Organization
Contact information
Practice address
218 OLD MOCKSVILLE RD, STATESVILLE, NC 28625-1930
(704) 838-7102
Mailing address
218 OLD MOCKSVILLE RD, STATESVILLE, NC 28625-1930
(704) 838-7102
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8000282
—
MS
Enumeration date
05/10/2007
Last updated
06/14/2010
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