Provider Demographics
NPI:1346379617
Name:DOWN EAST RESPIRATORY
Entity Type:Organization
Organization Name:DOWN EAST RESPIRATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FEREBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-830-2094
Mailing Address - Street 1:700 CROMWELL DRIVE
Mailing Address - Street 2:STE B
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5436
Mailing Address - Country:US
Mailing Address - Phone:252-830-2094
Mailing Address - Fax:252-355-7358
Practice Address - Street 1:700 CROMWELL DRIVE
Practice Address - Street 2:STE B
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5436
Practice Address - Country:US
Practice Address - Phone:252-830-2094
Practice Address - Fax:252-355-7358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC90229332800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7701391Medicaid
NC7701391Medicaid