Basic Information
Provider Information
NPI: 1508001009
EntityType: 2
ReplacementNPI:  
OrganizationName: COLUMBUS REGIONAL HEALTH NETWORK
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: CAROLINAS HOSPITALIST GROUP - COLUMBUS
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: PO BOX 19305
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282199305
CountryCode: US
TelephoneNumber: 7046310002
FaxNumber:  
Practice Location
Address1: 500 JEFFERSON ST
Address2:  
City: WHITEVILLE
State: NC
PostalCode: 284723634
CountryCode: US
TelephoneNumber: 9106421776
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/11/2008
LastUpdateDate: 08/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ARMSTRONG
AuthorizedOfficialFirstName: MARVIN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 7043552000
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: COLUMBUS REGIONAL HEALTH NETWORK
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X  N193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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