Organization
EAST CAROLINA HEALTH
Active
Other names
Roanoke Chowan Urology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON GRAHAM (CHIEF FINANCIAL OFFICER)
(252) 209-3610
Entity
Organization
Contact information
Practice address
312 ACADEMY ST S STE A, AHOSKIE, NC 27910-3200
(252) 332-6444
(252) 332-5417
Mailing address
312 ACADEMY ST S STE A, AHOSKIE, NC 27910-3200
(252) 332-6444
(252) 332-5417
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018H1
BCBS GROUP ID
NC
05
—
5903831
—
NC
01
—
CH9789
RR MEDICARE
NC
Enumeration date
06/12/2006
Last updated
01/06/2009
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