Healthcare Provider Details

I. General information

NPI: 1760660310
Provider Name (Legal Business Name): MARIA PARHAM MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2008
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

566 RUIN CREEK RD
HENDERSON NC
27536-2927
US

IV. Provider business mailing address

566 RUIN CREEK RD P. O. BOX 59
HENDERSON NC
27536-2927
US

V. Phone/Fax

Practice location:
  • Phone: 252-436-1118
  • Fax:
Mailing address:
  • Phone: 252-436-1118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number StateNC

VIII. Authorized Official

Name: MRS. DENISE D SMITH
Title or Position: LIFELINE MANAGER
Credential:
Phone: 252-436-1118