Provider Demographics
NPI:1881798072
Name:CRAWLEY MEMORIAL HOSPITAL INC
Entity type:Organization
Organization Name:CRAWLEY MEMORIAL HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:COYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-487-3802
Mailing Address - Street 1:201 E GROVER ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150
Mailing Address - Country:US
Mailing Address - Phone:704-476-7439
Mailing Address - Fax:704-476-7417
Practice Address - Street 1:315 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28017
Practice Address - Country:US
Practice Address - Phone:704-476-7439
Practice Address - Fax:704-476-7417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3400104Medicaid
00487OtherBCBS
00487OtherBCBS
=========OtherCHAMPUS
NC340104Medicare Oscar/Certification