Healthcare Provider Details

I. General information

NPI: 1700749124
Provider Name (Legal Business Name): EASTERN CAROLINA MEDICAL CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL DR
BENSON NC
27504-1177
US

IV. Provider business mailing address

1 MEDICAL DR
BENSON NC
27504-1177
US

V. Phone/Fax

Practice location:
  • Phone: 919-207-1027
  • Fax: 919-207-1032
Mailing address:
  • Phone: 919-207-1027
  • Fax: 919-207-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LORI FENNELL CAPPS
Title or Position: FINANCIAL CONTROLLER
Credential:
Phone: 919-894-5787