Organization Name: | EAST CAROLINA HEALTH - CHOWAN INC |
NPI Number: | 1336102144 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEFFREY N. SACKRISON (PRESIDENT) |
Mailing Address: | 203 Earnhardt Dr Edenton |
State: | NC US |
Postal Code: | 279328401 |
Phone Number: | 2524822134 |
Fax Number: | 2524825529 |
NPI Enumeration Date: | 04/11/2006 |
NPI Last Update Date: | 07/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | 200200358 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |