Organization
BLADEN HEALTHCARE, LLC
Active
Parent organization
CUMBERLAND COUNTY HEALTH SYSTEM INC
Other names
Cape Fear Valley BMA Bladenboro
Organization subpart
Yes
Provider details
NPI number
Legal business name
CUMBERLAND COUNTY HEALTH SYSTEM INC
Authorized official
JOSEPH B FISER (VP CORP REVENUE CYCLE/MANAGED CARE)
(910) 615-5572
Entity
Organization
Contact information
Practice address
1106 W SEABOARD ST, BLADENBORO, NC 28320-6985
(910) 863-3138
(910) 863-3597
Mailing address
PO BOX 40908, ATTN: PFS PROVIDER ENROLLMENT, FAYETTEVILLE, NC 28309
(910) 862-6308
(910) 862-5501
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
H0154
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34-4601A
—
NC
Enumeration date
05/05/2008
Last updated
11/19/2023
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