Provider Demographics
NPI:1356675011
Name:MOREHEAD MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:MOREHEAD MEMORIAL HOSPITAL
Other - Org Name:SMITH MCMICHAEL CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF PHYSICIANS
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-623-9711
Mailing Address - Street 1:117 E KINGS HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5201
Mailing Address - Country:US
Mailing Address - Phone:336-623-9711
Mailing Address - Fax:
Practice Address - Street 1:516 SOUTH VAN BUREN ROAD
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5019
Practice Address - Country:US
Practice Address - Phone:336-623-9713
Practice Address - Fax:336-623-1031
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOREHEAD MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22485207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty