MEDICARE: DUPLIN GENERAL HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	H0166	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00995	OTHER	NC	BCBS OF NC SKILLED NURSIN

General Provider Information

NPI Number	:	1538135876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUPLIN GENERAL HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 278
Second Line	:
City	:	KENANSVILLE
State	:	NC
Zip	:	28349-0278
Country	:	US
Telephone Number	:	910-296-2603
Fax Number	:	910-296-1174

Provider Business Practice Location Address
First Line	:	401 NORTH MAIN STREET
Second Line	:
City	:	KENANSVILLE
State	:	NC
Zip	:	28349
Country	:	US
Telephone Number	:	910-296-2603
Fax Number	:	910-296-1174

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	MR. W HARVEY CASE
Credential	:
Telephone Number	:	910-296-2602

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	08/22/2020

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