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General NPI Number Information
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NPI Number | 1508986944
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Entity Type | Organization
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Legal Business Name | SAMPSON REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 508 BEAMAN ST
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City | CLINTON
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State | NC
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Zip | 28328-2602
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Country | US
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Telephone | 910-590-5312
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Fax | 910-590-5305
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Provider Business Mailing Address
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Address Line | 607 BEAMAN ST
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City | CLINTON
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State | NC
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Zip | 28328-2603
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Country | US
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Telephone | 910-596-4262
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Fax | 910-592-5461
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Authorized Official
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Title or Position | CEO
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Name | GERALD THOMAS HEINZMAN JR.
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Credential |
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Telephone | 910-590-8729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC0257
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License Number State | NC
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