Provider Demographics
NPI:1508859075
Name:BEAUFORT COUNTY HOSPITAL ASSOCIATION, INC.
Entity Type:Organization
Organization Name:BEAUFORT COUNTY HOSPITAL ASSOCIATION, INC.
Other - Org Name:BEAUFORT REGIONAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEDSOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-975-4100
Mailing Address - Street 1:604 E. 12TH STREET
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3405
Mailing Address - Country:US
Mailing Address - Phone:252-975-8330
Mailing Address - Fax:252-948-4801
Practice Address - Street 1:604 E. 12TH STREET
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3405
Practice Address - Country:US
Practice Address - Phone:252-975-8330
Practice Address - Fax:252-948-4801
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEAUFORT COUNTY HOSPITAL ASSOCIATION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-30
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1634163WH0200X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3417115Medicaid
NC3417115Medicaid
NC347115Medicare UPIN