Provider Demographics
NPI:1164503702
Name:DUPLIN MEDICAL ASSOCIATION INC
Entity Type:Organization
Organization Name:DUPLIN MEDICAL ASSOCIATION INC
Other - Org Name:ROSE HILL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-289-3027
Mailing Address - Street 1:600 SOUTH SYCAMORE STREET
Mailing Address - Street 2:PO BOX 639
Mailing Address - City:ROSE HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28458
Mailing Address - Country:US
Mailing Address - Phone:910-289-3027
Mailing Address - Fax:910-289-2894
Practice Address - Street 1:600 SOUTH SYCAMORE STREET
Practice Address - Street 2:
Practice Address - City:ROSE HILL
Practice Address - State:NC
Practice Address - Zip Code:28458
Practice Address - Country:US
Practice Address - Phone:910-289-3027
Practice Address - Fax:910-289-2894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QR1300X
NC101600363AM0700X
NC103247363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0107MOtherBCBS
NC343914AMedicaid
NC343914CMedicaid
NC2330736Medicare PIN
NC343914CMedicaid