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General NPI Number Information
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NPI Number | 1982913422
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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 | 10/01/2010
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Last Update Date | 01/11/2017
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Provider Practice Location Address
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Address Line | 24420 MARLBORO STREET
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City | WAGRAM
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State | NC
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Zip | 28396-9600
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Country | US
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Telephone | 919-369-3136
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Fax | 910-369-4756
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Provider Business Mailing Address
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Address Line | PO BOX 602458
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City | CHARLOTTE
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State | NC
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Zip | 28260-2458
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Country | US
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Telephone | 910-369-3136
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Fax | 910-369-4756
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Authorized Official
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Title or Position | TREASURER
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Name | MATHEW DAVID 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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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