Healthcare Provider Details

I. General information

NPI: 1003660663
Provider Name (Legal Business Name): UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 AIRPORT RD
KINSTON NC
28501-1603
US

IV. Provider business mailing address

5221 PARAMOUNT PKWY STE 440
MORRISVILLE NC
27560-5491
US

V. Phone/Fax

Practice location:
  • Phone: 252-527-4146
  • Fax:
Mailing address:
  • Phone: 984-974-1190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: LATONYA FELICA BROWN
Title or Position: CFO
Credential:
Phone: 984-974-1145