Healthcare Provider Details
I. General information
NPI: 1518263268
Provider Name (Legal Business Name): COLUMBUS REGIONAL HEALTH NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/28/2011
Last Update Date: 03/09/2023
Certification Date: 12/29/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
619 JEFFERSON ST
WHITEVILLE NC
28472-3707
US
IV. Provider business mailing address
PO BOX 19305
CHARLOTTE NC
28219-9305
US
V. Phone/Fax
- Phone: 910-642-0331
- Fax:
- Phone: 704-631-0002
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARVIN
ARMSTRONG
Title or Position: CFO
Credential:
Phone: 704-355-2000