| South Robeson Medical Center | |
|
1212 S Walnut St Fairmont NC 28340 | |
| (910) 628-6711 | |
| (910) 628-5735 |
| Full Name | South Robeson Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1212 S Walnut St, Fairmont, North Carolina |
| Authorized Official Name and Position | George Timothy Hall (PRESIDENT/CEO) |
| Authorized Official Contact | 9105212900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Robeson Medical Center 60 Commerce Plz Pembroke NC 28372-7386 Ph: (910) 521-2900 | South Robeson Medical Center 1212 S Walnut St Fairmont NC 28340 Ph: (910) 628-6711 |
| NPI Number | 1417914722 |
|---|---|
| Provider Enumeration Date | 04/28/2006 |
| Last Update Date | 08/16/2018 |
| Medicare PECOS PAC ID | 1850290693 |
|---|---|
| Medicare Enrollment ID | O20050512000053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417914722 | NPI | - | NPPES |
| 344570 A/C | Medicaid | NC | |
| 6005792 | Medicaid | NC |
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