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General NPI Number Information
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NPI Number | 1801270053
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Entity Type | Organization
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Legal Business Name | NC OCME
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 4312 DISTRICT DR
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City | RALEIGH
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State | NC
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Zip | 27607-5490
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Country | US
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Telephone | 919-743-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 3025 MAIL SERVICE CTR
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City | RALEIGH
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State | NC
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Zip | 27699-3025
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL EXAMINER
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Name | DR. DEBORAH RADISCH
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Credential | M.D.
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Telephone | 919-743-9000
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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 | 2014-00007
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License Number State | NC
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