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General NPI Number Information
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NPI Number | 1982673034
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Entity Type | Organization
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Legal Business Name | PENDER MEMORIAL HOSPITAL, INCORPORATED
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 507 E FREMONT ST
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City | BURGAW
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State | NC
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Zip | 28425-5131
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Country | US
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Telephone | 910-259-5451
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Fax |
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Provider Business Mailing Address
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Address Line | 507 E FREMONT ST
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City | BURGAW
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State | NC
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Zip | 28425-5131
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Country | US
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Telephone | 910-259-5451
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/SITE EXECUTIVE OFFICE
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Name | MR. DAVID H. LONG
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Credential |
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Telephone | 910-259-5451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | H0115
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License Number State | NC
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