Organization
ALBEMARLE HOSPITAL AUTHORITY
Active
Other names
ALBEMARLE HOSPITAL PROFESSIONAL STAFF
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND C OWINGS (CFO)
(252) 384-4168
Entity
Organization
Contact information
Practice address
1144 N ROAD ST, ELIZABETH CITY, NC 27909-3473
(252) 384-4168
(252) 384-4677
Mailing address
1144 N ROAD ST, ELIZABETH CITY, NC 27909-3473
(252) 384-4168
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014TK
BCBS
NC
01
—
07734
BLUE CROSS ID
NC
01
—
2352735
MEDICARE PTAN
NC
05
—
89014PG
—
NC
Enumeration date
02/27/2007
Last updated
05/16/2012
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