Healthcare Provider Details

I. General information

NPI: 1326168980
Provider Name (Legal Business Name): HARBORSIDE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2807 NEUSE BLVD
NEW BERN NC
28562-2815
US

IV. Provider business mailing address

2807 NEUSE BLVD
NEW BERN NC
28562-2815
US

V. Phone/Fax

Practice location:
  • Phone: 252-636-2990
  • Fax: 252-637-6011
Mailing address:
  • Phone: 252-636-2990
  • Fax: 252-637-6011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS A BULL
Title or Position: OWNER
Credential: MD
Phone: 252-636-2990