Organization
EAST CAROLINA HEALTH
Active
Other names
Ahoskie Heart Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON GRAHAM (C.F.O.)
(252) 209-3610
Entity
Organization
Contact information
Practice address
700 ACADEMY ST S, AHOSKIE, NC 27910-3264
(252) 209-5404
(252) 209-5405
Mailing address
PO BOX 1385, AHOSKIE, NC 27910-1385
(252) 209-5404
(252) 209-5405
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018J0
BLUE CROSS BLUE SHIELD
NC
05
—
5905072
—
NC
05
—
7000499
—
NC
01
—
CH9789
RR MEDICARE
NC
Enumeration date
09/12/2006
Last updated
04/28/2008
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