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General NPI Number Information
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NPI Number | 1508041666
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Entity Type | Organization
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Legal Business Name | MOYE MEDICAL ENDOSCOPY CENTER LLC
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 09/24/2014
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Provider Practice Location Address
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Address Line | 521-C MOYE BLVD
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City | GREENVILLE
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State | NC
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Zip | 27834-2849
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Country | US
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Telephone | 252-744-8400
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Fax | 252-744-6601
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Provider Business Mailing Address
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Address Line | 2100 STANTONSBURG RD
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City | GREENVILLE
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State | NC
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Zip | 27834-2818
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Country | US
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Telephone | 252-847-7479
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Fax | 252-847-6372
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Authorized Official
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Title or Position | VP OF CANCER & CLINICAL SERVICES
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Name | MR. RYAN TODD HICKEY
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Credential |
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Telephone | 252-847-7836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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