=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821076589
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EAST CAROLINA HEALTH - HERITAGE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2006
-----------------------------------------------------
Last Update Date | 03/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1473 NC 42-43 WEST
-----------------------------------------------------
City | PINETOPS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27864-7188
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-827-5231
-----------------------------------------------------
Fax | 252-827-5775
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1473 NC 42-43 WEST
-----------------------------------------------------
City | PINETOPS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27864-7188
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-827-5231
-----------------------------------------------------
Fax | 252-827-5775
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. PATRICK M HEINS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 252-641-7123
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR1300X
-----------------------------------------------------
Taxonomy Name | Rural Health Clinic/Center
-----------------------------------------------------
License Number | H0258
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------