Organization
EAST CAROLINA HEALTH
Active
Parent organization
EAST CAROLINA HEALTH
Other names
Vidant Roanoke Chowan Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAST CAROLINA HEALTH
Authorized official
MR. JON GRAHAM (CFO)
(252) 209-3610
Entity
Organization
Contact information
Practice address
608 ACADEMY ST S, AHOSKIE, NC 27910-3239
(252) 209-3690
(252) 209-3691
Mailing address
PO BOX 1385, AHOSKIE, NC 27910-1385
(252) 209-3690
(252) 209-3691
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021A3
BCBS
NC
05
—
5950665
—
NC
Enumeration date
12/12/2008
Last updated
05/31/2012
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