# MOREHEAD MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Practice of Eden
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629170147
- **Authorized official:** TAMARA L. HUNT (VP OF PRACTICE MANAGEMENT)
- **Authorized official phone:** (336) 623-9711

## Contact information

- **Practice address:** 515 THOMPSON ST, \#D, EDEN, NC 27288-5068
- **Practice address phone:** (336) 627-5178
- **Mailing address:** 515 THOMPSON ST, \#D, EDEN, NC 27288-5068
- **Mailing address phone:** (336) 627-5178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/04/2006
- **Last updated:** 03/02/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0129X | BLUE CROSS | NC |
| 01 | — | 235082G | MEDICARE GRP PIN | NC |
| 01 | — | 5950636 | MEDICAID GROUP \# - EFFECTIVE 1/1/09 | NC |
| 01 | — | 890129X | MEDICAID GROUP \# TERMINATED 3/1/09 | NC |