Healthcare Provider Details

I. General information

NPI: 1053351031
Provider Name (Legal Business Name): WASHINGTON REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 05/11/2020
Certification Date: 05/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

958 US HIGHWAY 64 E
PLYMOUTH NC
27962-9216
US

IV. Provider business mailing address

7920 BELT LINE RD STE 215
DALLAS TX
75254-8155
US

V. Phone/Fax

Practice location:
  • Phone: 252-793-4135
  • Fax: 252-793-1530
Mailing address:
  • Phone: 214-502-9624
  • Fax: 252-793-1530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: FRANK TITUS AVIGNONE IV
Title or Position: CEO
Credential:
Phone: 214-502-9624