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General NPI Number Information
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NPI Number | 1720013162
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Entity Type | Organization
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Legal Business Name | BLADEN COUNTY HOSPITAL
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 501 S POPLAR ST
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337-9375
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Country | US
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Telephone | 910-862-5100
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Fax | 910-862-1238
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Provider Business Mailing Address
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Address Line | PO BOX 398
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337-0398
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Country | US
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Telephone | 910-862-5100
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Fax | 910-862-1238
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Authorized Official
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Title or Position | CEO
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Name | MR. DAVID MASTERSON
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Credential |
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Telephone | 910-862-5179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | H0154
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License Number State | NC
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