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General NPI Number Information
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NPI Number | 1225078611
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Entity Type | Organization
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Legal Business Name | JOHNSTON MEMORIAL HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 70 CRAPE MYRTLE DR SUITE 104
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City | BENSON
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State | NC
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Zip | 27504-8034
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Country | US
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Telephone | 919-938-0260
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Fax | 919-938-0350
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Provider Business Mailing Address
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Address Line | 509 N BRIGHTLEAF BLVD P.O. BOX 1376
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City | SMITHFIELD
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State | NC
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Zip | 27577-4407
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Country | US
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Telephone | 919-934-8171
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Fax | 919-989-7297
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | RAYMOND EDWARD SIMPSON
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Credential |
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Telephone | 919-938-7128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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