Provider Demographics
NPI:1033264221
Name:PITT COUNTY AMBULATORY INFUSION CENTER
Entity Type:Organization
Organization Name:PITT COUNTY AMBULATORY INFUSION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSTICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-695-6380
Mailing Address - Street 1:503 BOWMAN GRAY DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7286
Mailing Address - Country:US
Mailing Address - Phone:252-695-6380
Mailing Address - Fax:252-695-6383
Practice Address - Street 1:2495 HEMBY LN
Practice Address - Street 2:SUITE A
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3771
Practice Address - Country:US
Practice Address - Phone:252-695-6380
Practice Address - Fax:252-695-6383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy