Yes
| DC | | 1467441394 |
| IN | | 1467441394 |
| MA | | 1467441394 |
| AZ | | 1467441394 |
| FL | | 1467441394 |
| GA | | 1467441394 |
| MD | | 1467441394 |
| NJ | | 1467441394 |
| NY | | 1467441394 |
| SC | | 1467441394 |
| VA | | 1467441394 |
| WV | | 1467441394 |
| MI | | 1467441394 |
| OH | | 1467441394 |
| AR | | 1467441394 |
| MO | | 1467441394 |
| TX | | 1467441394 |
| NC | | 1467441394,1043218944,1598272379,1285198283,1780359687 |
| DSH340099A | Child | DSH | East Carolina Health d/b/a ECU Health Roanoke-Chowan Hospital | Outpatient Clinic (PT) | 604 South Academy St | Ahoskie | NC | Active |
| DSH340099B | Child | DSH | East Carolina Health d/b/a ECU Health Roanoke-Chowan Hospital | ECU Health Roanoke-Chowan Wound Center | 608 South Academy St | Ahoskie | NC | Active |
| DSH340099C | Child | DSH | East Carolina Health d/b/a ECU Health Roanoke-Chowan Hospital | Pain Management Anesthesiology Services | 606 A South Academy St | Ahoskie | NC | Active |
| DSH340099D | Child | DSH | East Carolina Health d/b/a ECU Health Roanoke-Chowan Hospital | SLEEP CENTER AT ECU HEALTH ROANOKE - Sleep | 1014 JERSEY ST | AHOSKIE | NC | Active |
| Contacts | Authorizing Official | Update | Change Request | Alford, Charles
Vice President, Financial Services
East Carolina Health-Heritage, Inc., d/b/a ECU Health Edgecombe Hospital
2526417131 | Harvill, brian Jeffrey
President
ECU Health Roanoke Chowan Hospital
2524826268 | 1/6/2025 10:53 AM |
| Details | State | Update | | Approved | Active | 1/1/2025 12:01 AM |
| Contacts | Signed By | Insert | New Registration | | Alford, Charles
Vice President, Financial Services
East Carolina Health-Heritage, Inc., d/b/a ECU Health Edgecombe Hospital
2526417131 | 10/18/2024 2:10 PM |
| Details | 340B ID | Update | New Registration | | DSH340099D | 10/18/2024 2:10 PM |
| Details | Entity Name | Update | New Registration | EAST CAROLINA HEALTH | East Carolina Health d/b/a ECU Health Roanoke-Chowan Hospital | 10/18/2024 2:10 PM |
| Details | Entity Subname | Update | New Registration | SLEEP CENTER AT ECU HEALTH ROANOKE | SLEEP CENTER AT ECU HEALTH ROANOKE - Sleep | 10/18/2024 2:10 PM |
| Dates | Participating Approval Date | Update | New Registration | | 10/18/2024 2:10:37 PM | 10/18/2024 2:10 PM |
| Details | State | Update | New Registration | Pending | Approved | 10/18/2024 2:10 PM |
| Dates | Signed By Date | Update | New Registration | | 10/14/2024 2:19:16 PM | 10/18/2024 2:10 PM |
| Dates | Start Date | Update | New Registration | | 1/1/2025 12:00:00 AM | 10/18/2024 2:10 PM |
| Addresses | Main Address | Insert | New Registration | |
1014 JERSEY ST
AHOSKIE, NC 27910 | 10/11/2024 2:19 PM |
| Addresses | Billing Address | Insert | New Registration | | ECU Health Accounts Payable
PO Box 6028
Greenville, NC 27835-6028 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | DC | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | IN | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | MA | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | AZ | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | FL | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | GA | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | MD | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | NJ | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | NY | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | SC | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | VA | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | WV | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | MI | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | OH | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | AR | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | MO | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | TX | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1467441394 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | NC | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1043218944 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | NC | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1598272379 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | NC | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1285198283 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | NC | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1780359687 | 10/11/2024 2:19 PM |
| Medicaid Billing | NPI: State | Insert | New Registration | | NC | 10/11/2024 2:19 PM |
| Contacts | Primary Contact | Insert | New Registration | | Sexton, Kelly Morgan
Pharmacy Manager
ECU Health
2522093141 | 10/11/2024 2:19 PM |
| Contacts | Authorizing Official | Insert | New Registration | | Alford, Charles
Vice President, Financial Services
East Carolina Health-Heritage, Inc., d/b/a ECU Health Edgecombe Hospital
2526417131 | 10/11/2024 2:19 PM |
| Details | Assistance Received From Date | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Details | Assistance Received To Date | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Details | Last Recertification Date | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Details | Grant Number | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Details | 340B ID | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Details | Medicare Provider Number | Insert | New Registration | | 340099 | 10/11/2024 2:19 PM |
| Details | Entity Name | Insert | New Registration | | EAST CAROLINA HEALTH | 10/11/2024 2:19 PM |
| Details | NOFO Number | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Details | Program Code | Insert | New Registration | | DSH | 10/11/2024 2:19 PM |
| Details | Entity Subname | Insert | New Registration | | SLEEP CENTER AT ECU HEALTH ROANOKE | 10/11/2024 2:19 PM |
| Dates | Participating Approval Date | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Details | State | Insert | New Registration | | Pending | 10/11/2024 2:19 PM |
| Dates | Registration Date | Insert | New Registration | | 10/11/2024 2:19:26 PM | 10/11/2024 2:19 PM |
| Dates | Signed By Date | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Dates | Start Date | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Terminations | Termination Comments | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Terminations | Termination Date | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Terminations | Termination Effective Date | Insert | New Registration | | | 10/11/2024 2:19 PM |
| Terminations | Termination Reason | Insert | New Registration | | | 10/11/2024 2:19 PM |