Provider Demographics
NPI:1053562223
Name:NASH MSO, INC.
Entity type:Organization
Organization Name:NASH MSO, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP, CFO
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HOOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-443-8077
Mailing Address - Street 1:2460 CURTIS ELLIS DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-2237
Mailing Address - Country:US
Mailing Address - Phone:252-962-8847
Mailing Address - Fax:252-962-3056
Practice Address - Street 1:2460 CURTIS ELLIS DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2237
Practice Address - Country:US
Practice Address - Phone:252-443-8077
Practice Address - Fax:252-443-8877
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NASH HEALTH CARE SYSTEMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-07
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5950795Medicaid
NC2344636Medicare PIN