Organization
STATESVILLE HMA LLC
Active
Organization
STATESVILLE HMA LLC
Active
Other names
Davis Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
218 OLD MOCKSVILLE RD, STATESVILLE, NC 28625-1930
(704) 838-7102
Mailing address
PO BOX 402332, ATLANTA, GA 30384-2332
(704) 873-0281
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3400144S
—
NC
Enumeration date
06/06/2006
Last updated
04/10/2024
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