Provider Demographics
NPI:1669503504
Name:THORASIC AND VASCULAR ASSOCIATES OF KINSTON
Entity Type:Organization
Organization Name:THORASIC AND VASCULAR ASSOCIATES OF KINSTON
Other - Org Name:LENOIR COUNTY AMBULATORY INFUSION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ART
Authorized Official - Middle Name:
Authorized Official - Last Name:BANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-695-6380
Mailing Address - Street 1:2508 N QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1631
Mailing Address - Country:US
Mailing Address - Phone:252-939-9300
Mailing Address - Fax:
Practice Address - Street 1:2508 N QUEEN ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1631
Practice Address - Country:US
Practice Address - Phone:252-939-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy