Eastern Medical Associates

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

9300226 Issued in NC

Legal business name

EASTERN MEDICAL ASSOCIATES

Practice address

2609 Medical Office PL
Goldsboro, NC 27534-9428

Phone

(919) 734-1779

NPI assigned

Oct 28, 2009

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenny Heine

Title

VP of Operations

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Tax ID family

Eastern Medical Associates2 organizations share this tax ID, including this one

Part of

Tri - State Medical Group Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eastern Medical Associates, PA

  • Family Medicine Physician
  • Pikeville, NC
  • NPI 1922045673
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388361600000",
    "number": "1861728792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349428",
            "telephone_number": "919-734-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN MEDICAL ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2009-10-28",
        "last_updated": "2013-12-30",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NC",
            "license": "9300226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-Pharmacy Dispensing Site in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Non-Pharmacy Dispensing Site in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.