Organization Name: | ECSU STUDENT HEALTH SERVICES |
NPI Number: | 1083056287 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | REGINA MCCOY-DAVIS (DIRECTOR) |
Mailing Address: | 1704 Weeksville Rd Elizabeth City |
State: | NC US |
Postal Code: | 279097977 |
Phone Number: | 2523353267 |
Fax Number: | 2523353269 |
NPI Enumeration Date: | 07/29/2013 |
NPI Last Update Date: | 07/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Student Health |
Taxonomy Definition: |