Provider Demographics
NPI:1194955120
Name:EASTERN CAROLINA PHARMACY CARE INC
Entity type:Organization
Organization Name:EASTERN CAROLINA PHARMACY CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:ROBERSON
Authorized Official - Last Name:PHILLIPPE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:252-523-6069
Mailing Address - Street 1:1302 W VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-3528
Mailing Address - Country:US
Mailing Address - Phone:252-253-6069
Mailing Address - Fax:252-523-3497
Practice Address - Street 1:1302 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-3528
Practice Address - Country:US
Practice Address - Phone:252-253-6069
Practice Address - Fax:252-523-3497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC162113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy