Healthcare Provider Details

I. General information

NPI: 1609857432
Provider Name (Legal Business Name): SAMPSON REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 BEAMAN ST
CLINTON NC
28328-2603
US

IV. Provider business mailing address

607 BEAMAN ST
CLINTON NC
28328-2603
US

V. Phone/Fax

Practice location:
  • Phone: 910-592-8511
  • Fax: 910-592-6451
Mailing address:
  • Phone: 910-592-8511
  • Fax: 910-592-5461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH0067
License Number StateNC

VIII. Authorized Official

Name: MR. GERALD T HEINZMAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 910-590-8729