Provider Demographics
NPI:1518206960
Name:SAMPSON REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:SAMPSON REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:T
Authorized Official - Last Name:HEINZMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:910-592-8729
Mailing Address - Street 1:607 BEAMAN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-2603
Mailing Address - Country:US
Mailing Address - Phone:910-592-8511
Mailing Address - Fax:
Practice Address - Street 1:607 BEAMAN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2603
Practice Address - Country:US
Practice Address - Phone:910-592-8511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit