PENDER MEMORIAL HOSPITAL, INC (NPI# 1346217676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346217676 |
| Entity Type | Organization |
| Organization Name | PENDER MEMORIAL HOSPITAL, INC |
| Other Organization Name | PENDER HOME HEALTH |
| Practice Address |
507 E Fremont St Burgaw NC 28425-5131 |
| Practice Telephone | 9102595451 |
| Mailing Telephone | 9102595451 |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2008-01-10 |
| Authorized Official Name | MR. DAVID LONG (SITE EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9102595451 |
| Authorized Official Credential | SEO |
| Is Organization Subpart | Y |
| Parent Organization Name | PENDER MEMORIAL HOSPITAL, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | HC0532 | NC | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3417065 | 05 | |
| NC | BCBS NC PROVIDER NUMBER | 0070N | 01 |
| Other Name | Type Code |
|---|---|
| Pender Home Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538137468 | Pender Memorial Hospital, Inc | Skilled Nursing Facility | 507 East Fremont Street, Burgaw, NC 28425-5131 | 2006-03-08 |
| Street Address |
507 E FREMONT ST |
| City | BURGAW |
| State | NC |
| Zip Code | 28425-5131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245886118 | Megan Lydon | Speech-Language Pathologist | 507 E Fremont St, Burgaw, NC 28425-5131 | 2019-08-15 |
| 1861839078 | Ann Elsasser | Physical Therapist | 507 E Fremont St, Burgaw, NC 28425-5131 | 2013-05-29 |
| 1184948648 | Heather L Downs D O PC | Family Medicine | 507 E Fremont St, Pender Memorial Hospital, Burgaw, NC 28425-5131 | 2010-03-26 |
| 1588986616 | R Henry Temple, Md., PC | Obstetrics & Gynecology | 507 E Fremont St, Burgaw, NC 28425-5131 | 2010-02-16 |
| 1467646471 | Benjamin Scott Wiles | Emergency Medicine | 507 E Fremont St, Burgaw, NC 28425-5131 | 2007-09-03 |
| 1033242987 | Pender Memorial Hospital Incorporated | General Acute Care Hospital | 507 E Fremont St, Burgaw, NC 28425-5131 | 2007-03-13 |
| 1053444901 | Pender Memorial Hospital Incorporated | General Acute Care Hospital | 507 E Fremont St, Burgaw, NC 28425-5131 | 2007-03-13 |
| 1801957675 | Pender Memorial Hospital Inc | Pharmacy | 507 E Fremont St, Burgaw, NC 28425-5131 | 2006-12-13 |
| 1255407680 | Ecep II Pa | Emergency Medicine | 507 E Fremont St, Burgaw, NC 28425-5131 | 2006-11-28 |
| 1023030756 | Pender Memorial Hospital Inc. | Medicare Defined Swing Bed Unit | 507 E Fremont St, Burgaw, NC 28425-5131 | 2006-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091662 | Chiquitta Williams Lesene | Counselor | 407 E Fremont Street, Burgaw, NC 28425 | 2020-10-22 |
| 1255978912 | David L Populus Jr. | Preventive Medicine | 1638 Hwy 53, Burgaw, NC 28425 | 2019-12-02 |
| 1467948729 | Coastal Horizons Center Inc. | Community/Behavioral Health | 309 Progress Dr., Burgaw, NC 28425 | 2018-07-10 |
| 1629504824 | Kellie Savard | Speech-Language Pathologist | 213 South Wright Street, Unit B, Burgaw, NC 28425 | 2017-05-08 |
| 1578004800 | Alisa Fussell | Speech-Language Pathologist | 10131 Highway 53 W, Burgaw, NC 28425 | 2017-03-20 |
| 1881136851 | Pender Pediatric Therapy, PC | Speech-Language Pathologist | 126 W. Fremont St., Burgaw, NC 28425 | 2016-11-08 |
| 1821424771 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 206 Us Highway 117 S, Burgaw, NC 28425 | 2013-09-24 |
| 1679816193 | Kerry Dawn Daraskavich | Physical Therapist | 311 South Campell Street, Burgaw, NC 28425 | 2013-04-03 |
| 1184985178 | Kerr Drug | Point of Service | 206 Us Route 117 South, Burgaw, NC 28425 | 2012-06-06 |
| 1407117682 | Courtney L Gibbs | Speech-Language Pathologist | 126 W Fremont St, Burgaw, NC 28425 | 2012-06-04 |
| Find all providers in zip 28425 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699827105 | Interim Healthcare of The Eastern Carolinas, Inc | Home Health | 126 W Fremont Street, Burgaw, NC 28425-5099 | 2007-01-17 |
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| 1144827858 | Angelic Care Touch Inc | Home Health | 8601 Six Forks Rd Ste 400478, Raleigh, NC 27615-5276 | 2020-10-06 |
| 1710584529 | Christopher Amadi Amadi | Home Health | 8601 Six Forks Rd Ste 47886016, Raleigh, NC 27615-5276 | 2020-10-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.