Provider Demographics
NPI:1134252018
Name:CAROLINAEAST HEALTH SYSTEM AUXILIARY
Entity type:Organization
Organization Name:CAROLINAEAST HEALTH SYSTEM AUXILIARY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER CHS AUXILIARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-634-6148
Mailing Address - Street 1:P.O. BOX 12157
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28561-2157
Mailing Address - Country:US
Mailing Address - Phone:252-633-8129
Mailing Address - Fax:252-633-8084
Practice Address - Street 1:2000 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28561-2157
Practice Address - Country:US
Practice Address - Phone:252-633-8129
Practice Address - Fax:252-633-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408130Medicaid