Healthcare Provider Details

I. General information

NPI: 1467917724
Provider Name (Legal Business Name): EAST CAROLINA ANESTHESIA ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2019
Last Update Date: 01/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2095 HENRY TECKLENBURG DR
CHARLESTON SC
29414-5733
US

IV. Provider business mailing address

2080 W ARLINGTON BLVD STE B
GREENVILLE NC
27834-3770
US

V. Phone/Fax

Practice location:
  • Phone: 843-402-1000
  • Fax: 770-701-6718
Mailing address:
  • Phone: 252-752-2140
  • Fax: 252-689-6502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA D SCHWARTZ
Title or Position: CHAIRMAN
Credential:
Phone: 252-752-2140