Organization
EAST CAROLINA HEALTH - CHOWAN INC
Active
Parent organization
EAST CAROLINA HEALTH - CHOWAN INC
Other names
Chowan Pediatrics
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAST CAROLINA HEALTH - CHOWAN INC
Authorized official
MR. JEFFREY N. SACKRISON (PRESIDENT)
(252) 482-6268
Entity
Organization
Contact information
Practice address
203 EARNHARDT DR, EDENTON, NC 27932-8401
(252) 482-7408
(252) 482-5529
Mailing address
PO BOX 569, EDENTON, NC 27932-0569
(252) 482-7408
(252) 482-5529
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
200200691
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012GF
BCBS PROVIDER #
NC
05
—
89012GF
—
NC
Enumeration date
04/10/2006
Last updated
07/14/2008
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