1467405431 NPI number — EASTERN CAROLINA PHYSICIANS P.A.

Table of content: (NPI 1467405431)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467405431 NPI number — EASTERN CAROLINA PHYSICIANS P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EASTERN CAROLINA PHYSICIANS P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467405431
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
744 AIRPORT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KINSTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28504-8800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-523-0026
Provider Business Mailing Address Fax Number:
252-523-1855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
744 AIRPORT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINSTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28504-8800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-523-0026
Provider Business Practice Location Address Fax Number:
252-523-1855
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HECK
Authorized Official First Name:
GARY
Authorized Official Middle Name:
HERSCHEL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
252-523-0026

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  40032 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8940896 . This is a "MEDICAID PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1033105739 . This is a "JOHN JOHN M.D. NPI #" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1306832001 . This is a "CHRISTIE WESTBROOK PA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1780670695 . This is a "GARY HECK D.O. NPI #" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 03216 . This is a "MEDICARE RAILROAD PTAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: G79098 . This is a "DR. JOHN K JOHN MEDICARE UPIN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8901960 . This is a "EASTERN CAROLINA PHYSICIANS GROUP MEDICAID FOR KINSTON" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 5905891 . This is a "DR CABUNGCAL MEDICAID PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: P45612 . This is a "MEDICARE UPIN CHRISTIE WESTBROOK PAC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1841234523 . This is a "NPI CABUNGCAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2064572 . This is a "DR CATHERINE CABUNGCAL MEDICARE PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 5908296 . This is a "EASTERN CAROLINA PHYSICIANS GROUP MEDICAID FOR BEULAVILLE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1043238587 . This is a "S FREDERICK NPI#" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1740361369 . This is a "NPI HEATHER TYNDALL" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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