Healthcare Provider Details

I. General information

NPI: 1700864980
Provider Name (Legal Business Name): EAST CAROLINA HEALTH - CHOWAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 05/30/2022
Certification Date: 05/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 VIRGINIA RD
EDENTON NC
27932-9668
US

IV. Provider business mailing address

PO BOX 629
EDENTON NC
27932-0629
US

V. Phone/Fax

Practice location:
  • Phone: 252-482-8451
  • Fax: 252-482-6274
Mailing address:
  • Phone: 252-482-8451
  • Fax: 252-482-6274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberH0063
License Number StateNC

VIII. Authorized Official

Name: MR. TODD J WARLITNER
Title or Position: CFO
Credential:
Phone: 252-482-6175