Healthcare Provider Details

I. General information

NPI: 1104327709
Provider Name (Legal Business Name): CUMBERLAND COUNTY HOSPITAL SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2018
Last Update Date: 11/24/2024
Certification Date: 11/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1738 METROMEDICAL DR
FAYETTEVILLE NC
28304-3861
US

IV. Provider business mailing address

PO BOX 40908
FAYETTEVILLE NC
28309-0908
US

V. Phone/Fax

Practice location:
  • Phone: 910-484-4191
  • Fax: 910-484-5546
Mailing address:
  • Phone: 910-615-6949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH BARTON FISER
Title or Position: VP CORPORATE REVENUE CYCLE
Credential:
Phone: 910-615-5572