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General NPI Number Information
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NPI Number | 1770622797
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Entity Type | Organization
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Legal Business Name | EAST CAROLINA UNIVERSITY
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 12/16/2014
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Provider Practice Location Address
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Address Line | 270 EASY ST
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City | GREENVILLE
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State | NC
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Zip | 27834-9012
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Country | US
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Telephone | 252-413-0063
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Fax | 252-413-0605
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Provider Business Mailing Address
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Address Line | PO BOX 75514
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City | CHARLOTTE
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State | NC
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Zip | 28275-0514
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Country | US
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Telephone | 252-744-1830
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Fax | 252-744-2709
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Authorized Official
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Title or Position | DIR OF PHRM SRV
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Name | JEFFREY JACKSON
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Credential |
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Telephone | 252-744-5990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | NC09462
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License Number State | NC
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