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General NPI Number Information
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NPI Number | 1346377041
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Entity Type | Organization
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Legal Business Name | BETHAMY ENTERPRISES INC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 102 ANN STREET
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City | SPENCER
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State | NC
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Zip | 28159-2818
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Country | US
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Telephone | 704-633-5212
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Fax |
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Provider Business Mailing Address
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Address Line | 909 ORTH SALISBURY AVE
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City | SPENCER
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State | NC
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Zip | 28159-2818
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Country | US
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Telephone | 704-633-5212
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SUSAN LANE MORRIS
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Credential |
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Telephone | 704-633-1985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | FCL-080-001
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License Number State | NC
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