Provider Demographics
NPI:1790849586
Name:UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL
Entity Type:Organization
Organization Name:UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL
Other - Org Name:UNC HOSPITALS EATING DISORDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ELLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-966-5111
Mailing Address - Street 1:211 FRIDAY CENTER DR
Mailing Address - Street 2:SUITE 2091, ROOM 2101
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9499
Mailing Address - Country:US
Mailing Address - Phone:919-966-0420
Mailing Address - Fax:919-966-9983
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-0420
Practice Address - Fax:919-966-9983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCH0157103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC001FPOtherBCBSNC PROV #