Provider Demographics
NPI:1538114244
Name:CAROLINAEAST MEDICAL CENTER
Entity Type:Organization
Organization Name:CAROLINAEAST MEDICAL CENTER
Other - Org Name:HOME CARE CRAVEN REGIONAL MEDICAL AUTHORITY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SHERRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-633-8880
Mailing Address - Street 1:1300 HELEN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-3418
Mailing Address - Country:US
Mailing Address - Phone:252-633-8185
Mailing Address - Fax:
Practice Address - Street 1:1300 HELEN AVE
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-3418
Practice Address - Country:US
Practice Address - Phone:252-633-8185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0165251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408055Medicaid