Provider Demographics
NPI:1730146267
Name:NASH OB-GYN ASSOCIATES, P.A.
Entity type:Organization
Organization Name:NASH OB-GYN ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-443-5941
Mailing Address - Street 1:200 NASH MEDICAL ARTS MALL
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-1470
Mailing Address - Country:US
Mailing Address - Phone:252-443-5941
Mailing Address - Fax:252-443-7059
Practice Address - Street 1:200 NASH MEDICAL ARTS MALL
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-1470
Practice Address - Country:US
Practice Address - Phone:252-443-5941
Practice Address - Fax:252-443-7059
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UWH OF NC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-27
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39290174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8902277Medicaid
NC230243Medicare PIN