Organization
SCOTLAND MEMORIAL HOSPITAL, INC
Active
Other names
Wagram Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
LUCIEN STONGE (CFO)
(910) 291-7547
Entity
Organization
Contact information
Practice address
24420 MARLBORO ST, WAGRAM, NC 28396-9600
(910) 369-3136
(910) 369-4756
Mailing address
24420 MARLBORO ST, WAGRAM, NC 28396-9600
(910) 369-3136
(910) 369-4756
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07171
BCBS
NC
05
—
89018PZ
—
NC
05
—
891261T
—
NC
05
—
NPB192
—
SC
Enumeration date
09/06/2005
Last updated
08/31/2022
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