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General NPI Number Information
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NPI Number | 1477687242
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Entity Type | Organization
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Legal Business Name | GASTROINTESTINAL HEALTHCARE PA
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 05/14/2014
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Provider Practice Location Address
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Address Line | 2011 FALLS VALLEY DR STE 106
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City | RALEIGH
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State | NC
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Zip | 27615-3451
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Country | US
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Telephone | 919-881-0743
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Fax | 919-881-0822
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Provider Business Mailing Address
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Address Line | 2011 FALLS VALLEY DR STE 106
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City | RALEIGH
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State | NC
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Zip | 27615-3451
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Country | US
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Telephone | 919-870-1311
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Fax | 919-881-0822
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. NANCY NICOLL O'NEILL
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Credential |
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Telephone | 919-870-1352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number |
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License Number State | NC
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