Provider Demographics
NPI:1780641373
Name:CAROLINAEAST MEDICAL CENTER
Entity Type:Organization
Organization Name:CAROLINAEAST MEDICAL CENTER
Other - Org Name:CAROLINAEAST REHABILITATION HOSPITAL
Other - Org Type:Other 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 1:2000 NEUSE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-3449
Mailing Address - Country:US
Mailing Address - Phone:252-633-8640
Mailing Address - Fax:252-636-5376
Practice Address - Street 1:2000 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-3449
Practice Address - Country:US
Practice Address - Phone:252-633-8640
Practice Address - Fax:252-636-5376
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINAEAST MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-27
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0201273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00133OtherNC BLUE CROSS
NC3400131TMedicaid
NC3400131TMedicaid