Healthcare Provider Details

I. General information

NPI: 1902135999
Provider Name (Legal Business Name): BEAUFORT COUNTY HOSPITAL ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2009
Last Update Date: 08/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 E 12TH ST
WASHINGTON NC
27889-3409
US

IV. Provider business mailing address

628 E 12TH ST
WASHINGTON NC
27889-3409
US

V. Phone/Fax

Practice location:
  • Phone: 252-948-4990
  • Fax: 252-948-4994
Mailing address:
  • Phone: 252-948-4990
  • Fax: 252-948-4994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number27339
License Number StateNC

VIII. Authorized Official

Name: DR. RANDALL EARL WHITE
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 252-948-4990