Provider Demographics
NPI:1518989946
Name:ALAMANCE REGIONAL MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:ALAMANCE REGIONAL MEDICAL CENTER, INC.
Other - Org Name:ALAMANCE REGIONAL - BEHAVORIAL MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:ASST. DIRECTOR PFS
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-538-8419
Mailing Address - Street 1:PO BOX 202
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27216-0202
Mailing Address - Country:US
Mailing Address - Phone:336-538-7000
Mailing Address - Fax:
Practice Address - Street 1:1240 HUFFMAN MILL RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8700
Practice Address - Country:US
Practice Address - Phone:336-538-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00359OtherBCBS PROVIDER #
NC3400070SMedicaid
NC=========OtherTRICARE PROVIDER #
NC3400070SMedicaid