Provider Demographics
NPI:1275079451
Name:COLUMBUS REGIONAL HEALTHCARE SYSTEM
Entity Type:Organization
Organization Name:COLUMBUS REGIONAL HEALTHCARE SYSTEM
Other - Org Name:DONAYRE CANCER CARE CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:BIBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-642-1773
Mailing Address - Street 1:504 JEFFESON ST
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472
Mailing Address - Country:US
Mailing Address - Phone:910-640-4075
Mailing Address - Fax:910-640-4616
Practice Address - Street 1:504 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-3634
Practice Address - Country:US
Practice Address - Phone:910-640-4075
Practice Address - Fax:910-640-4616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
NC111043336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2167224OtherPK