Provider Demographics
NPI:1558657874
Name:EAST COAST INSTITUTE FOR RESEARCH, LLC
Entity Type:Organization
Organization Name:EAST COAST INSTITUTE FOR RESEARCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:904-854-1354
Mailing Address - Street 1:11701-32 SAN JOSE BLVD.
Mailing Address - Street 2:SUITE 108
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-1884
Mailing Address - Country:US
Mailing Address - Phone:904-854-1354
Mailing Address - Fax:904-854-1355
Practice Address - Street 1:11701-32 SAN JOSE BLVD.
Practice Address - Street 2:SUITE 108
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-1884
Practice Address - Country:US
Practice Address - Phone:904-854-1354
Practice Address - Fax:904-854-1355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37778261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch