Provider Demographics
NPI:1780183426
Name:CUMBERLAND COUNTY HOSPITAL SYSTEM INC
Entity Type:Organization
Organization Name:CUMBERLAND COUNTY HOSPITAL SYSTEM INC
Other - Org Name:CFV PRIMARY CARE-WALTER REED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP CORPORATE REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:B
Authorized Official - Last Name:FISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-615-5572
Mailing Address - Street 1:PO BOX 40908
Mailing Address - Street 2:ATTN: PFS PROVIDER ENROLLMENT
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28309-0908
Mailing Address - Country:US
Mailing Address - Phone:910-615-6949
Mailing Address - Fax:
Practice Address - Street 1:1218 WALTER REED RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4440
Practice Address - Country:US
Practice Address - Phone:910-488-6337
Practice Address - Fax:910-488-1384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty