Provider Demographics
NPI:1780969394
Name:SCOTLAND REGIONAL HEALTH NETWORK
Entity type:Organization
Organization Name:SCOTLAND REGIONAL HEALTH NETWORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:PRACHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-291-7920
Mailing Address - Street 1:PO BOX 602458
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2458
Mailing Address - Country:US
Mailing Address - Phone:910-276-7552
Mailing Address - Fax:910-277-0531
Practice Address - Street 1:705B LAUCHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5544
Practice Address - Country:US
Practice Address - Phone:910-276-7552
Practice Address - Fax:910-277-0531
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCOTLAND REGIONAL HEALTH NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-14
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5918881Medicaid
SCNPB456Medicaid
SCNPB456Medicaid