Organization Name: | HOLDEN BEACH MEDICAL CENTER, PA |
NPI Number: | 1053547976 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HEATHER MERROW (OWNER) |
Mailing Address: | 2930 Holden Beach Rd Sw Supply |
State: | NC US |
Postal Code: | 284625702 |
Phone Number: | 9108425991 |
Fax Number: | 9108425994 |
NPI Enumeration Date: | 06/05/2009 |
NPI Last Update Date: | 06/05/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 103587 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |