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General NPI Number Information
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NPI Number | 1891135067
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Entity Type | Organization
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Legal Business Name | SCOTLAND REGIONAL HEALTH NETWORK
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Dates
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Enumeration Date | 07/02/2013
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 410 S JONES ST STE D
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City | PEMBROKE
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State | NC
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Zip | 28372-7261
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Country | US
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Telephone | 910-277-9164
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19305
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City | CHARLOTTE
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State | NC
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Zip | 28219-9305
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Country | US
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Telephone | 704-631-0002
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | MATTHEW PRACHT
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Credential |
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Telephone | 910-291-7920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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