| Easter Seals Ucp North Carolina & Virginia, Inc. | |
|
1600 Wayne Memorial Dr Suite F Goldsboro NC 27534-2201 | |
| (919) 587-0001 | |
| (919) 587-0007 |
| Full Name | Easter Seals Ucp North Carolina & Virginia, Inc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1600 Wayne Memorial Dr, Goldsboro, North Carolina |
| Authorized Official Name and Position | Richard P Edwards (VICE PRESIDENT) |
| Authorized Official Contact | 9197838898 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Seals Ucp North Carolina & Virginia, Inc. 5171 Glenwood Ave Suite 400 Raleigh NC 27612-3266 Ph: (919) 783-8898 | Easter Seals Ucp North Carolina & Virginia, Inc. 1600 Wayne Memorial Dr Suite F Goldsboro NC 27534-2201 Ph: (919) 587-0001 |
| NPI Number | 1083776348 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 11/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083776348 | NPI | - | NPPES |
| 8300746 | Medicaid | NC | |
| 018KJ | Other | NC | NC BCBS GROUP |
| 8300746A | Medicaid | NC | |
| 8300746F | Medicaid | NC | |
| 8300746G | Medicaid | NC | |
| 8300746I | Medicaid | NC | |
| 8300746B | Medicaid | NC | |
| 8300746H | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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