Organization
EAST CAROLINA HEALTH
Active
Other names
Psychiatric Associates of Ahoskie
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON GRAHAM (CHIEF FINANCIAL OFFICER)
(252) 209-3610
Entity
Organization
Contact information
Practice address
113B HERTFORD COUNTY HIGH RD, AHOSKIE, NC 27910-8131
(252) 209-8161
(252) 209-6011
Mailing address
PO BOX 1385, AHOSKIE, NC 27910-1385
(252) 209-8161
(252) 209-6011
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016VG
BCBS GROUP #
NC
05
—
5900004
—
NC
05
—
6005065
—
NC
01
—
CH9789
RR MEDICARE
NC
Enumeration date
01/05/2006
Last updated
08/17/2018
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