Basic Information
Provider Information
NPI: 1992184543
EntityType: 2
ReplacementNPI:  
OrganizationName: SCOTLAND MEMORIAL HOSPITAL, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: WOMEN'S HEALTH CENTER OF THE CAROLINAS
OtherOrganizationType: 3
OtherLastName:  
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OtherLastNameType:  
Mailing Information
Address1: PO BOX 604093
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282604093
CountryCode: US
TelephoneNumber: 9102917000
FaxNumber: 9102773336
Practice Location
Address1: 105 MCALPINE LN
Address2:  
City: LAURINBURG
State: NC
PostalCode: 283524637
CountryCode: US
TelephoneNumber: 9102773331
FaxNumber: 9102773336
Other Information
ProviderEnumerationDate: 05/28/2015
LastUpdateDate: 09/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STONGE
AuthorizedOfficialFirstName: LUCIEN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 9102917547
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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