NPIMap

Organization Active NPI

Scotland Memorial Hospital Inc

Doing business as Marlboro Family Practice and Urgent Care

  • Rural Health Clinic/Center
  • Bennettsville, SC
National Provider Identifier
1770577611
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SCOTLAND MEMORIAL HOSPITAL INC
Doing business as
Marlboro Family Practice and Urgent Care
Practice address
957 Cheraw St
Bennettsville, SC 29512-2420
Phone
(843) 454-0245
Fax
(843) 479-7873
NPI assigned
Sep 7, 2005
Last updated
Aug 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lucien Stonge
Title
Cfo
Phone
(864) 366-3310

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

957 Cheraw St
Bennettsville, SC 29512-2420

Mailing address

PO Box 2257
Laurinburg, NC 28353-2257
Phone (843) 454-0245

Other names 1

  • MARLBORO FAMILY PRACTICE AND URGENT CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080304000638 SC Part B Supplier - Clinic/Group Practice 0648208504 Receives reassigned benefits from 27 practitioners
3 other NPIs on this enrollment
Practice locations: Bennettsville, SC
O20180622001263 NC Part A Provider - Rural Health Clinic 0648208504 Practice locations: Bennettsville, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770577611. Details of each certification follow.

Rural health clinic certification: CCN 423461

Legal name
SCOTLAND MEMORIAL HOSPITAL, INC
Doing business as
MARLBORO FAMILY PRACTICE AND URGENT CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 24, 2017
Last certification
Aug 24, 2017
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Nov 26, 1947 in NC
Enrollment address
957 Cheraw St
Bennettsville, SC 29512-2420
Related CCNs
340008

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D0976820Marlboro Family Practice and Urgent Care957 Cheraw Street, Bennettsville, SC 29512Provider-performed microscopyAug 14, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 25

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Milton Farmer Individual Corporate Director Jan 1, 2009
Scotland Memorial Hospital, Inc Organization, Laurinburg, NC Corporation Operational/Managerial Control Dec 1, 2015
Pamela Ashley Individual Corporate OfficerCorporate Secretary Apr 1, 2009
Gregory Clark Wood Individual Contracted Managing EmployeeCeo/ Managerial Apr 1, 2009
Corporate OfficerCeo Apr 1, 2009
Matthew David Pracht Individual Contracted Managing Employee Apr 1, 2009
Corporate Officer Apr 1, 2009
Ronald Mercer Individual Corporate Director Jan 1, 2011
David Harling Individual Corporate Director Jan 1, 2010
Jane Rogers Individual Corporate OfficerVice Chairman Jan 1, 2016
Corporate Director Jan 1, 2010
Bradford Keith Faulkenberry Individual Corporate Director Jan 1, 2016
Kenneth Nichols Individual Corporate Director Jan 1, 2015
Michael Odonnell Individual Corporate Director Jan 1, 2009
Plummer R Chavis Individual Corporate Director Jan 1, 2008
Nancy Louise Walker Individual Corporate Director Jan 1, 2010
Donna M Richardson Individual Corporate Director Jan 1, 2012
Kyle Chavis Individual Corporate Director Jan 1, 2010
Stephen L Lanuti Individual Corporate Director Jan 1, 2014
Joshua Malcolm Individual Corporate Director Jan 1, 2011
Michael Vinson Individual Corporate Officer Jan 1, 2016
Corporate Director Jan 1, 2007
Dennis Stone Individual Corporate Director Jan 1, 2015
Wilbur Gene Shytle Individual Corporate Director Jan 1, 2013
John Ray Nobles Individual Corporate Director Jan 1, 2016
Robert N Hinson Individual Corporate Director Jan 1, 2014
Rebecca Hughes Individual Corporate Director Jan 1, 2014
Charlotte-Mecklenburg Hospital Authority Organization, Charlotte, NC Corporation Operational/Managerial Control Apr 9, 2009
Henry Allen McLaurin Individual Corporate Director Jan 1, 2013

Owners & managing parties with NPI records 14

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 14

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1770577611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283532257",
            "telephone_number": "843-454-0245",
            "fax_number": "843-479-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "957 CHERAW ST",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122420",
            "telephone_number": "843-454-0245",
            "fax_number": "843-479-7873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTLAND MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "STONGE",
        "authorized_official_first_name": "LUCIEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-366-3310"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARLBORO FAMILY PRACTICE AND URGENT CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MARLBORO FAMILY PRACTICE AND URGENT CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bennettsville, SC

Sources for this page

Verify at the official NPI Registry.