Healthcare Provider Details

I. General information

NPI: 1497293120
Provider Name (Legal Business Name): ECU PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2017
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HEART DR
GREENVILLE NC
27834-8982
US

IV. Provider business mailing address

101 HEART DR
GREENVILLE NC
27834-8982
US

V. Phone/Fax

Practice location:
  • Phone: 252-744-4611
  • Fax:
Mailing address:
  • Phone: 252-744-4611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberF01171199
License Number StateNC

VIII. Authorized Official

Name: DR. NICHOLAS H BENSON
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 252-744-2290