Healthcare Provider Details

I. General information

NPI: 1194703884
Provider Name (Legal Business Name): EAST CAROLINA HEALTH - HERITAGE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 HOSPITAL DR
TARBORO NC
27886-2011
US

IV. Provider business mailing address

111 HOSPITAL DR
TARBORO NC
27886-2011
US

V. Phone/Fax

Practice location:
  • Phone: 252-641-7700
  • Fax:
Mailing address:
  • Phone: 252-641-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberH0258
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberH0258
License Number StateNC

VIII. Authorized Official

Name: MR. PATRICK M HEINS
Title or Position: PRESIDENT
Credential:
Phone: 252-641-7123