Provider Demographics
NPI:1003013806
Name:SUNSET CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:SUNSET CHIROPRACTIC P.C.
Other - Org Name:MOORE CHIROPRACTIC INJURY & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:252-824-3003
Mailing Address - Street 1:2005 N MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-2132
Mailing Address - Country:US
Mailing Address - Phone:252-824-3003
Mailing Address - Fax:252-824-3004
Practice Address - Street 1:2005 N MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-2132
Practice Address - Country:US
Practice Address - Phone:252-824-3003
Practice Address - Fax:252-824-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1984OtherNC LICENSE #
350051113OtherMEDICARE RAILROAD
08658OtherBCBS #
NC8908658Medicaid
1984OtherNC LICENSE #
U43430Medicare UPIN