Organization
HEALTHEAST OUTER BANKS MEDICAL CENTER LLC
Active
Other names
Healtheast Family Care-Avon
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNN T. LANIER (VP OF FINANCE FOR EAST CAROLINA HEA)
(252) 847-7479
Entity
Organization
Contact information
Practice address
40894 HWY 12, AVON, NC 27915
(252) 995-3073
Mailing address
40894 HWY 12, AVON, NC 27915
(252) 995-3073
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0290R
BCBS PROVIDER #
NC
05
—
790290R
—
NC
Enumeration date
04/05/2006
Last updated
06/16/2008
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