Healthcare Provider Details
I. General information
NPI: 1558599449
Provider Name (Legal Business Name): BEAUFORT COUNTY HOSPITAL ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2009
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1095 MAIN ST
SWAN QUARTER NC
27885-0000
US
IV. Provider business mailing address
1095 MAIN ST
SWAN QUARTER NC
27885-0000
US
V. Phone/Fax
- Phone: 252-926-3751
- Fax: 252-926-9502
- Phone: 252-926-3751
- Fax: 252-926-9502
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUSAN
S
GERARD
Title or Position: MEDICAL PRACTICE ADMINISTRATOR
Credential:
Phone: 252-975-4206