1245521020 NPI number — EASTERN CAROLINA MEDICAL CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245521020 NPI number — EASTERN CAROLINA MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EASTERN CAROLINA MEDICAL CENTER
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:
EASTERN CAROLINA MEDICAL CENTER PHARMACY
Provider Other Organization Name Type Code:
3
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:
1245521020
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 MEDICAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BENSON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27504-1177
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-207-1027
Provider Business Mailing Address Fax Number:
919-207-1032

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 MEDICAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BENSON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27504-1177
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-207-1027
Provider Business Practice Location Address Fax Number:
919-207-1032
Provider Enumeration Date:
04/27/2011

Additional Information

Authorized Official

Authorized Official Last Name:
VYAS
Authorized Official First Name:
PANKAJ
Authorized Official Middle Name:
KIRTIKANT
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
919-897-5787

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  10997 , 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)





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