| Organization Name: | SAMPSON REGIONAL PROFESSIONAL SERVICES LLC |
| NPI Number: | 1619251766 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GERALD HEINZMAN (VP/ CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 301 Main St Newton Grove |
| State: | NC US |
| Postal Code: | 283667723 |
| Phone Number: | 9105941063 |
| Fax Number: | |
| NPI Enumeration Date: | 10/07/2011 |
| NPI Last Update Date: | 10/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |