Provider Demographics
NPI:1740384239
Name:EAST CAROLINA HEALTH
Entity Type:Organization
Organization Name:EAST CAROLINA HEALTH
Other - Org Name:AHOSKIE HEART CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.F.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-209-3610
Mailing Address - Street 1:PO BOX 1385
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-1385
Mailing Address - Country:US
Mailing Address - Phone:252-209-5404
Mailing Address - Fax:252-209-5405
Practice Address - Street 1:700 ACADEMY ST S
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3264
Practice Address - Country:US
Practice Address - Phone:252-209-5404
Practice Address - Fax:252-209-5405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCCH9789OtherRR MEDICARE
NC7000499Medicaid
NC5905072Medicaid
NC018J0OtherBLUE CROSS BLUE SHIELD
NCCH9789OtherRR MEDICARE