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General NPI Number Information
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NPI Number | 1801086558
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Entity Type | Organization
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Legal Business Name | SAMPSON REGIONAL MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 607 BEAMAN ST ANESTHESIA DEPARTMENT
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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 | 910-592-8511
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 890235
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City | CHARLOTTE
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State | NC
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Zip | 28289-0235
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Country | US
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Telephone | 800-919-1190
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Fax | 706-737-2272
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | GERALD T HEINZMAN JR.
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Credential |
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Telephone | 910-592-8511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State | NC
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