NPIMap

Organization Active NPI

Pender Memorial Hospital, Incorporated

  • Nursing Facility/Intermediate Care Facility
  • Burgaw, NC
National Provider Identifier
1982673034
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
H0115 Issued in NC
Legal business name
PENDER MEMORIAL HOSPITAL, INCORPORATED
Practice address
507 E Fremont St
Burgaw, NC 28425-5131
Phone
(910) 259-5451
NPI assigned
Mar 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Authorized official

Name
Mr. David H. Long
Title
Administrator/Site Executive Office
Phone
(910) 259-5451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X H0115 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) 259-5451

Other identifiers 1

IdentifierTypeStateIssuer
3496571MedicaidNC

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": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251936000000",
    "number": "1982673034",
    "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": "910-259-5451"
        },
        {
            "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": "910-259-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENDER MEMORIAL HOSPITAL, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2009-09-03",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "ADMINISTRATOR/SITE EXECUTIVE OFFICE",
        "authorized_official_telephone_number": "910-259-5451",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NC",
            "license": "H0115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3496571",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Sep 3, 2009; 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.