Organization
CCHC ENDOSCOPY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN W NUCKOLLS (ADMINISTRATOR)
(252) 514-6685
Entity
Organization
Contact information
Practice address
975 NEWMAN RD, NEW BERN, NC 28562-5252
(252) 514-6644
(252) 638-2626
Mailing address
975 NEWMAN RD, NEW BERN, NC 28562-5252
(252) 514-6644
(252) 638-2626
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QE0800X
Endoscopy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0061Y
BCBS
NC
05
—
3409944
—
NC
Enumeration date
07/13/2006
Last updated
03/21/2022
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