Provider Demographics
NPI:1376537555
Name:COLUMBUS REGIONAL HEALTHCARE SYSTEM
Entity Type:Organization
Organization Name:COLUMBUS REGIONAL HEALTHCARE SYSTEM
Other - Org Name:SOUTH COLUMBUS MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-642-8011
Mailing Address - Street 1:500 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-3634
Mailing Address - Country:US
Mailing Address - Phone:910-642-8011
Mailing Address - Fax:910-642-9328
Practice Address - Street 1:500 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:910-642-8011
Practice Address - Fax:910-642-9328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0045282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3400068Medicaid
NCA000001DAGTYEAROtherEHR CERTIFICATION NUMBER
NCA000001DAGTYEAROtherEHR CERTIFICATION NUMBER