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General NPI Number Information
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NPI Number | 1649235797
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Entity Type | Organization
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Legal Business Name | PUNGO DISTRICT HOSPITAL CORPORATION
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | 202 E WATER ST
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City | BELHAVEN
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State | NC
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Zip | 27810-1450
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Country | US
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Telephone | 252-943-2111
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Fax | 252-944-2236
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Provider Business Mailing Address
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Address Line | 202 E WATER ST
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City | BELHAVEN
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State | NC
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Zip | 27810-1450
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Country | US
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Telephone | 252-943-2111
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Fax | 252-944-2236
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HARVEY CASE
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Credential |
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Telephone | 252-944-2208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | H0002
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License Number State | NC
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