Organization
MOREHEAD MEMORIAL HOSPITAL
Active
Other names
Family Practice of Eden
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA L. HUNT (VP OF PRACTICE MANAGEMENT)
(336) 623-9711
Entity
Organization
Contact information
Practice address
515 THOMPSON ST, #D, EDEN, NC 27288-5068
(336) 627-5178
Mailing address
515 THOMPSON ST, #D, EDEN, NC 27288-5068
(336) 627-5178
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
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
Enumeration date
09/04/2006
Last updated
03/02/2009
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