Healthcare Provider Details

I. General information

NPI: 1508859075
Provider Name (Legal Business Name): BEAUFORT COUNTY HOSPITAL ASSOCIATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 04/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 E. 12TH STREET
WASHINGTON NC
27889-3405
US

IV. Provider business mailing address

604 E. 12TH STREET
WASHINGTON NC
27889-3405
US

V. Phone/Fax

Practice location:
  • Phone: 252-975-8330
  • Fax: 252-948-4801
Mailing address:
  • Phone: 252-975-8330
  • Fax: 252-948-4801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberHC1634
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC1634
License Number StateNC

VIII. Authorized Official

Name: BILL R. BEDSOLE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 252-975-4100