Provider Demographics
NPI:1801080114
Name:MOREHEAD MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:MOREHEAD MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF PRACTICE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-623-9711
Mailing Address - Street 1:518 S VANBUREN ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5299
Mailing Address - Country:US
Mailing Address - Phone:336-627-0362
Mailing Address - Fax:336-627-0778
Practice Address - Street 1:518 S VANBUREN ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5299
Practice Address - Country:US
Practice Address - Phone:336-627-0362
Practice Address - Fax:336-627-0778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC235082Medicare PIN