NPIMap

Organization Active NPI

Pender Memorial Hospital Inc

  • Institutional Pharmacy
  • Burgaw, NC
National Provider Identifier
1801957675
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
02290 Issued in NC
Legal business name
PENDER MEMORIAL HOSPITAL INC
Practice address
507 E Fremont St
Burgaw, NC 28425-5131
Phone
(910) 259-0704
Fax
(910) 259-9420
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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

Authorized official

Name
George Willets, RPH
Title
Dir of Phcy
Phone
(910) 259-0704

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Institutional Pharmacy 3336I0012X 02290 NC Primary

Addresses

Primary practice location

507 E Fremont St
Burgaw, NC 28425-5131

Mailing address

507 E Fremont St
Burgaw, NC 28425-5131
Phone (910) 259-0704

Other identifiers 2

IdentifierTypeStateIssuer
2065212OtherPK
0715078MedicaidNC

Other names 1

  • PENDER MEMORIAL HOSPITAL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pender Memorial Hospital7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463097600000",
    "number": "1801957675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 E FREMONT ST",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284255131",
            "telephone_number": "910-259-0704",
            "fax_number": "910-259-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 E FREMONT ST",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284255131",
            "telephone_number": "910-259-0704",
            "fax_number": "910-259-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENDER MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-05-13",
        "status": "A",
        "authorized_official_last_name": "WILLETS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "DIR OF PHCY",
        "authorized_official_telephone_number": "910-259-0704",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NC",
            "license": "02290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2065212",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0715078",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PENDER MEMORIAL HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burgaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.