Healthcare Provider Details

I. General information

NPI: 1396684635
Provider Name (Legal Business Name): HALIFAX REGIONAL MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 SMITH CHURCH RD
ROANOKE RAPIDS NC
27870-4914
US

IV. Provider business mailing address

250 SMITH CHURCH RD
ROANOKE RAPIDS NC
27870-4914
US

V. Phone/Fax

Practice location:
  • Phone: 252-537-1717
  • Fax:
Mailing address:
  • Phone: 252-535-8147
  • Fax: 252-535-8481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. RYAN TODD HICKEY
Title or Position: PRESIDENT
Credential:
Phone: 252-535-8159