1497954796 NPI number — HEALTH CARE OPTIONS OF THE EAST

Table of content: (NPI 1497954796)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497954796 NPI number — HEALTH CARE OPTIONS OF THE EAST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH CARE OPTIONS OF THE EAST
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:
1497954796
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 304
Provider Second Line Business Mailing Address:
819 NORTH BROAD ST.
Provider Business Mailing Address City Name:
EDENTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27932-0304
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-482-5561
Provider Business Mailing Address Fax Number:
252-482-5062

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
819 N BROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDENTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27932-1431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-482-5561
Provider Business Practice Location Address Fax Number:
252-482-5062
Provider Enumeration Date:
07/16/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHERRY
Authorized Official First Name:
DAWN
Authorized Official Middle Name:
BROWN
Authorized Official Title or Position:
OWNER/ DIRECTOR OF NURSES
Authorized Official Telephone Number:
252-482-5561

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HC2341 , 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)