Basic Information
| Provider Information | |||||||||
| NPI: | 1497476642 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CUMBERLAND COUNTY HEALTH SYSTEM INC | ||||||||
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| OtherOrganizationName: | CFV VASCULAR SPECIALISTS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 40908 | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283090908 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1251 OLIVER ST | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283044450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9108226587 | ||||||||
| FaxNumber: | 9104266587 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2022 | ||||||||
| LastUpdateDate: | 09/16/2022 | ||||||||
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| AuthorizedOfficialLastName: | FISER | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP REVENUE CYCLE/MANAGED CARE | ||||||||
| AuthorizedOfficialTelephone: | 9106155572 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.