=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114905783
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EAST CAROLINA HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2006
-----------------------------------------------------
Last Update Date | 03/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 111 HERTFORD COUNTY HIGH RD
-----------------------------------------------------
City | AHOSKIE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27910-8131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-209-3056
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 111 HERTFORD COUNTY HIGH RD
-----------------------------------------------------
City | AHOSKIE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27910-8131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-209-3056
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. BRIAN J HARVILL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 252-209-3173
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 273R00000X
-----------------------------------------------------
Taxonomy Name | Psychiatric Hospital Unit
-----------------------------------------------------
License Number | H0001
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------