Healthcare Provider Details

I. General information

NPI: 1356040802
Provider Name (Legal Business Name): EAST CAROLINA COMPASS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 BARNES ST S
WILSON NC
27893-5001
US

IV. Provider business mailing address

4500 DEWFIELD DR N
WILSON NC
27896-8997
US

V. Phone/Fax

Practice location:
  • Phone: 252-290-5535
  • Fax:
Mailing address:
  • Phone: 252-290-5535
  • Fax: 984-960-1976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JUSTIN BARNES
Title or Position: DIRECTOR
Credential:
Phone: 252-290-5535