Provider Demographics
NPI:1447273305
Name:CUMBERLAND COUNTY HOSPITAL SYSTEM INC
Entity type:Organization
Organization Name:CUMBERLAND COUNTY HOSPITAL SYSTEM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TART
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:910-433-3608
Mailing Address - Street 1:6387 RAMSEY ST
Mailing Address - Street 2:STE 130
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-9441
Mailing Address - Country:US
Mailing Address - Phone:910-615-3900
Mailing Address - Fax:910-321-6220
Practice Address - Street 1:6387 RAMSEY ST
Practice Address - Street 2:STE 130
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-9441
Practice Address - Country:US
Practice Address - Phone:910-615-3900
Practice Address - Fax:910-321-6220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC092413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3405467OtherNCPDP PROVIDER IDENTIFICATION NUMBER