Healthcare Provider Details

I. General information

NPI: 1275549925
Provider Name (Legal Business Name): HOT SPRINGS HEALTH PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 02/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 GUNTERTOWN RD
MARSHALL NC
28753-7806
US

IV. Provider business mailing address

PO BOX 69
MARSHALL NC
28753-0069
US

V. Phone/Fax

Practice location:
  • Phone: 828-656-2611
  • Fax: 828-656-9434
Mailing address:
  • Phone: 828-649-0800
  • Fax: 828-649-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number03007
License Number StateNC

VIII. Authorized Official

Name: PAUL DEMPSEY
Title or Position: PHCY DIR
Credential: PHARM D
Phone: 828-649-0800