MEDICARE: CUMBERLAND COUNTY HOSPITAL SYSTEM INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134162597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUMBERLAND COUNTY HOSPITAL SYSTEM INC

Provider Business Mailing Address
First Line	:	PO BOX 40908
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28309-0908
Country	:	US
Telephone Number	:	910-609-6448
Fax Number	:	910-609-7040

Provider Business Practice Location Address
First Line	:	6387 RAMSEY ST UNIT 100
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-9442
Country	:	US
Telephone Number	:	910-609-3879
Fax Number	:	910-321-6219

Authorized Official
Title or Position	:	VP MANAGED CARE AND REVENUE CYCLE
Name	:	JOSEPH B FISER
Credential	:
Telephone Number	:	910-615-5572

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	01/19/2024

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