Healthcare Provider Details

I. General information

NPI: 1902561392
Provider Name (Legal Business Name): KINSTON COMMUNITY HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 N QUEEN ST STE A
KINSTON NC
28501-4932
US

IV. Provider business mailing address

PO BOX 2278
KINSTON NC
28502-2278
US

V. Phone/Fax

Practice location:
  • Phone: 252-549-0847
  • Fax: 252-525-4876
Mailing address:
  • Phone: 252-522-9800
  • Fax: 252-523-9790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE FREEMAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 252-522-9800