Provider Demographics
NPI:1700287869
Name:CUMBERLAND COUNTY HOSPITAL SYSTEM INC
Entity Type:Organization
Organization Name:CUMBERLAND COUNTY HOSPITAL SYSTEM INC
Other - Org Name:CAPE FEAR VALLEY GASTROENTEROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP MANAGED CARE AND 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 1:1638 OWEN DR
Mailing Address - Street 2:ATTN: MANAGED CARE PLANNING
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3424
Mailing Address - Country:US
Mailing Address - Phone:910-615-4000
Mailing Address - Fax:910-615-9761
Practice Address - Street 1:1638 OWEN DR
Practice Address - Street 2:ATTN: MANAGED CARE PLANNING
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3424
Practice Address - Country:US
Practice Address - Phone:910-615-4000
Practice Address - Fax:910-615-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0213207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty