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General NPI Number Information
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NPI Number | 1326360579
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Entity Type | Organization
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Legal Business Name | NORTH CAROLINA CENTRAL UNIVERSITY
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Dates
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Enumeration Date | 02/15/2010
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 200 CAFETERIA DRIVE STUDENT HEALTH BUILDING
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City | DURHAM
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State | NC
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Zip | 27707-0020
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Country | US
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Telephone | 919-530-6317
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Fax | 919-530-7969
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Provider Business Mailing Address
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Address Line | P.O. BOX 19491 STUDENT HEALTH BUILDING
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City | DURHAM
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State | NC
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Zip | 27707-0020
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Country | US
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Telephone | 919-530-6317
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Fax | 919-530-7969
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. IESCHECIA NYTONYA GRAHAM ALLEN
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Credential | M.S., RHIT
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Telephone | 919-530-7908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 34D0688623
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License Number State | NC
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