Healthcare Provider Details

I. General information

NPI: 1497757785
Provider Name (Legal Business Name): CUMBERLAND COUNTY HOSPITAL SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 12/26/2023
Certification Date: 12/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 WALTER REED RD
FAYETTEVILLE NC
28304-4415
US

IV. Provider business mailing address

PO BOX 40908
FAYETTEVILLE NC
28309-0908
US

V. Phone/Fax

Practice location:
  • Phone: 910-615-3500
  • Fax: 910-615-3560
Mailing address:
  • Phone: 910-615-6448
  • Fax: 910-615-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

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