1902077936 NPI number — ONSLOW MEMORIAL HOSPITAL, INC.

Table of content: (NPI 1902077936)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902077936 NPI number — ONSLOW MEMORIAL HOSPITAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONSLOW MEMORIAL HOSPITAL, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HOSPITAL PATHOLOGY GROUP
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902077936
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3020 SHRINE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRUNSWICK
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31520-4743
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-267-0533
Provider Business Mailing Address Fax Number:
912-267-7313

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
317 WESTERN BLVD
Provider Second Line Business Practice Location Address:
ATTN: ROBIN SHEPARD, BILLING SUPERVISOR
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28546-6338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-577-4772
Provider Business Practice Location Address Fax Number:
910-577-4706
Provider Enumeration Date:
03/18/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
ROY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
910-577-2985

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)