MEDICARE: DUPLIN GENERAL HOSPITAL, 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	208M00000X	Hospitalist Physician

General Provider Information

NPI Number	:	1790919967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUPLIN GENERAL HOSPITAL, INC

Provider Business Mailing Address
First Line	:	401 N MAIN STREET
Second Line	:
City	:	KENANSVILLE
State	:	NC
Zip	:	28349-0278
Country	:	US
Telephone Number	:	910-296-0941
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 N MAIN STREET
Second Line	:
City	:	KENANSVILLE
State	:	NC
Zip	:	28349-0278
Country	:	US
Telephone Number	:	910-296-0941
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. W HARVEY CASE
Credential	:
Telephone Number	:	910-296-2603

Provider Enumeration Date	:	05/04/2009
Last Update Date	:	05/04/2009

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