Provider Demographics
NPI:1598272379
Name:PITT COUNTY MEMORIAL HOSPITAL INC.
Entity Type:Organization
Organization Name:PITT COUNTY MEMORIAL HOSPITAL INC.
Other - Org Name:ECU HEALTH SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:G
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-847-9602
Mailing Address - Street 1:P.O. BOX 6028
Mailing Address - Street 2:ROOM 1CC-1105
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835-6028
Mailing Address - Country:US
Mailing Address - Phone:252-816-2900
Mailing Address - Fax:252-816-2901
Practice Address - Street 1:2100 STANTONSBURG RD.
Practice Address - Street 2:ROOM 1CC-1105, PHARMACY
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834
Practice Address - Country:US
Practice Address - Phone:252-816-2900
Practice Address - Fax:252-816-2901
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PITT COUNTY MEMORIAL HOSPITAL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-03
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13421OtherBOARD OF PHARMACY PERMIT