Provider Demographics
NPI:1649899279
Name:QUEENS EMPIRE HEALTH
Entity type:Organization
Organization Name:QUEENS EMPIRE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIRAMZADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:910-548-2818
Mailing Address - Street 1:3280 HENDERSON DR STE C-1
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-5289
Mailing Address - Country:US
Mailing Address - Phone:910-548-2818
Mailing Address - Fax:
Practice Address - Street 1:3280 HENDERSON DR STE C-1
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5289
Practice Address - Country:US
Practice Address - Phone:910-548-2818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty