Provider Demographics
NPI:1831130798
Name:BENSON AREA MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:BENSON AREA MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIXIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:NUNNERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-894-2011
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:3333 NC HIGHWAY 242 N
Mailing Address - City:BENSON
Mailing Address - State:NC
Mailing Address - Zip Code:27504-0399
Mailing Address - Country:US
Mailing Address - Phone:919-894-2011
Mailing Address - Fax:919-894-7645
Practice Address - Street 1:3333 NC HIGHWAY 242 N
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:NC
Practice Address - Zip Code:27504-7844
Practice Address - Country:US
Practice Address - Phone:919-894-2011
Practice Address - Fax:919-894-7645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207Q00000X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0110EOtherBLUE CROSS BLUE SHIELD
NC343931Medicaid
NC0110EOtherBLUE CROSS BLUE SHIELD
NC343931Medicare ID - Type UnspecifiedRHC