Provider Demographics
NPI:1205206489
Name:EASTERN CAROLINA MEDICAL CENTER PC
Entity Type:Organization
Organization Name:EASTERN CAROLINA MEDICAL CENTER PC
Other - Org Name:ECMC DIABETES CENTER OF EXCELLENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIABETES EDUCATION MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RITESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-207-1027
Mailing Address - Street 1:1 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:NC
Mailing Address - Zip Code:27504-1177
Mailing Address - Country:US
Mailing Address - Phone:919-207-1027
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:NC
Practice Address - Zip Code:27504-1177
Practice Address - Country:US
Practice Address - Phone:919-207-1027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASTERN CAROLINA MEDICAL CENTER PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Single Specialty
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty