Provider Demographics
NPI:1437580107
Name:NORTH CAROLINA CENTRAL UNIVERSITY
Entity Type:Organization
Organization Name:NORTH CAROLINA CENTRAL UNIVERSITY
Other - Org Name:NORTH CAROLINA CENTRAL UNIVERSITY
Other - Org Type:Other Name
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TYRONE
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-530-5485
Mailing Address - Street 1:1801 FAYETTEVILLE STREET
Mailing Address - Street 2:STUDENT HEALTH BUILDING
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707
Mailing Address - Country:US
Mailing Address - Phone:919-530-7336
Mailing Address - Fax:919-530-7969
Practice Address - Street 1:200 CAFETERIA DRIVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707
Practice Address - Country:US
Practice Address - Phone:919-530-6317
Practice Address - Fax:919-530-7969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health