Organization
PERSON COUNTY MEMORIAL PROFESSION STAFF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG C JAMES CEO (ADMINISTRATOR)
(336) 599-2121
Entity
Organization
Contact information
Practice address
615 RIDGE RD, ROXBORO, NC 27573-4629
(336) 599-2121
(336) 503-5660
Mailing address
615 RIDGE RD, ROXBORO, NC 27573-4629
(336) 599-2121
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
H0066
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0764B
BLUE CROSS GROUP NUMBER
NC
Enumeration date
05/02/2006
Last updated
08/22/2020
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