Provider Demographics
NPI:1902135999
Name:BEAUFORT COUNTY HOSPITAL ASSOCIATION INC
Entity Type:Organization
Organization Name:BEAUFORT COUNTY HOSPITAL ASSOCIATION INC
Other - Org Name:WHITE RHEUMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-948-4990
Mailing Address - Street 1:628 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3409
Mailing Address - Country:US
Mailing Address - Phone:252-948-4990
Mailing Address - Fax:252-948-4994
Practice Address - Street 1:628 E 12TH ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3409
Practice Address - Country:US
Practice Address - Phone:252-948-4990
Practice Address - Fax:252-948-4994
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEAUFORT COUNTY HOSPITAL ASSOCIATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-22
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27339207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty