Provider Demographics
NPI:1760797294
Name:MOREHEAD MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:MOREHEAD MEMORIAL HOSPITAL
Other - Org Name:MOREHEAD FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
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 1:518 SOUTH VAN BUREN ROAD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5033
Mailing Address - Country:US
Mailing Address - Phone:336-623-9711
Mailing Address - Fax:
Practice Address - Street 1:518 S VAN BUREN RD
Practice Address - Street 2:SUITE 9
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5033
Practice Address - Country:US
Practice Address - Phone:336-623-9711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty