Provider Demographics
NPI:1093904278
Name:MED CAREEAST P A
Entity Type:Organization
Organization Name:MED CAREEAST P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HATHAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:252-758-5888
Mailing Address - Street 1:1425 EAST FIRETOWER ROAD
Mailing Address - Street 2:100
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4131
Mailing Address - Country:US
Mailing Address - Phone:252-758-5888
Mailing Address - Fax:252-758-9888
Practice Address - Street 1:2485 HEMBY LN
Practice Address - Street 2:D
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3733
Practice Address - Country:US
Practice Address - Phone:252-758-5888
Practice Address - Fax:252-758-9888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty