Provider Demographics
NPI:1902890742
Name:SCOTLAND MEMORIAL HOSPITAL, INC
Entity Type:Organization
Organization Name:SCOTLAND MEMORIAL HOSPITAL, INC
Other - Org Name:SCOTLAND INPATIENT REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LUCIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STONGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-291-7547
Mailing Address - Street 1:PO BOX 604093
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-4093
Mailing Address - Country:US
Mailing Address - Phone:910-291-7171
Mailing Address - Fax:910-291-7180
Practice Address - Street 1:500 LAUCHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5501
Practice Address - Country:US
Practice Address - Phone:910-291-7000
Practice Address - Fax:910-291-7499
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCOTLAND INPATIENT REHABILITATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-08
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3400008TMedicaid
SC259192Medicaid
NC3400008TMedicaid