Healthcare Provider Details

I. General information

NPI: 1336235795
Provider Name (Legal Business Name): EASTERN CAROLINA CASE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 08/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 BEACON DR SUITE I
WINTERVILLE NC
28590-7860
US

IV. Provider business mailing address

564 VERNON WHITE RD
WINTERVILLE NC
28590-8672
US

V. Phone/Fax

Practice location:
  • Phone: 252-353-1114
  • Fax:
Mailing address:
  • Phone: 252-531-2902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. LESLEY DOVER
Title or Position: OWNER/DIRECTOR OF OPERATIONS
Credential:
Phone: 252-531-2902