Healthcare Provider Details

I. General information

NPI: 1851153183
Provider Name (Legal Business Name): CUMBERLAND COUNTY HOSPITAL SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2024
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417B VANCE ST
CLINTON NC
28328-4001
US

IV. Provider business mailing address

PO BOX 40908
FAYETTEVILLE NC
28309-0908
US

V. Phone/Fax

Practice location:
  • Phone: 910-596-5633
  • Fax: 910-596-0977
Mailing address:
  • Phone: 910-615-6949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH B FISER
Title or Position: VP MANAGED CARE AND REVENUE CYCLE
Credential:
Phone: 910-615-5572