Provider Demographics
NPI:1851342075
Name:AHOSKIE PEDIATRICS, P.A.
Entity Type:Organization
Organization Name:AHOSKIE PEDIATRICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:EDWARDS
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-332-3403
Mailing Address - Street 1:700 MCGLOHON ST N
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-2249
Mailing Address - Country:US
Mailing Address - Phone:252-332-8740
Mailing Address - Fax:252-332-1655
Practice Address - Street 1:700 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3547
Practice Address - Country:US
Practice Address - Phone:252-332-3403
Practice Address - Fax:252-332-1655
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AHOSKIE PEDIATRICS, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-12
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890160MMedicaid