Basic Information
| Provider Information | |||||||||
| NPI: | 1578708368 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | APP-ECP, LLC | ||||||||
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| OtherOrganizationName: | EASTERN CAROLINA PATHOLOGY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 658 GRASSMERE PARK STE 104 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372113683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159163200 | ||||||||
| FaxNumber: | 6159163218 | ||||||||
| Practice Location | |||||||||
| Address1: | 2693 FOREST HILLS RD SW | ||||||||
| Address2: | SUITE B | ||||||||
| City: | WILSON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27893 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522342841 | ||||||||
| FaxNumber: | 2522349270 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2008 | ||||||||
| LastUpdateDate: | 12/29/2021 | ||||||||
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| AuthorizedOfficialLastName: | PAPAIOANU | ||||||||
| AuthorizedOfficialFirstName: | ATHANASSIOS | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT & CEO | ||||||||
| AuthorizedOfficialTelephone: | 6159163200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | 34D0947174 | Y | Laboratories | Clinical Medical Laboratory |
ID Information
| ID | Type | State | Issuer | Description | 1578708368 | 05 | NC | MEDICAID |