Healthcare Provider Details

I. General information

NPI: 1083842264
Provider Name (Legal Business Name): BEAUFORT COUNTY HOSPITAL ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 06/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 WASHINGTON ST
PLYMOUTH NC
27962-2224
US

IV. Provider business mailing address

804 WASHINGTON ST
PLYMOUTH NC
27962-2224
US

V. Phone/Fax

Practice location:
  • Phone: 252-793-1154
  • Fax: 252-793-3860
Mailing address:
  • Phone: 252-793-1154
  • Fax: 252-793-3860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSAN S GERARD
Title or Position: MEDICAL PRACTICE ADMINISTRATOR
Credential:
Phone: 252-975-4203