Healthcare Provider Details

I. General information

NPI: 1033264221
Provider Name (Legal Business Name): PITT COUNTY AMBULATORY INFUSION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2495 HEMBY LN SUITE A
GREENVILLE NC
27834-3771
US

IV. Provider business mailing address

503 BOWMAN GRAY DR SUITE D
GREENVILLE NC
27834-7286
US

V. Phone/Fax

Practice location:
  • Phone: 252-695-6380
  • Fax: 252-695-6383
Mailing address:
  • Phone: 252-695-6380
  • Fax: 252-695-6383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DOUG BOSTICK
Title or Position: CEO
Credential:
Phone: 252-695-6380