Provider Demographics
NPI:1376676148
Name:DOWN EAST HEALTH CARE LLC
Entity type:Organization
Organization Name:DOWN EAST HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:ATTORNEY
Authorized Official - Phone:252-520-7543
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NC
Mailing Address - Zip Code:27962-0186
Mailing Address - Country:US
Mailing Address - Phone:252-520-7543
Mailing Address - Fax:252-520-1917
Practice Address - Street 1:126 W LENOIR AVE
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-4312
Practice Address - Country:US
Practice Address - Phone:252-520-7543
Practice Address - Fax:252-750-1917
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOWN EAST HEALTH CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-13
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2405251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301704Medicaid