Provider Demographics
NPI:1316823750
Name:EAST CAROLINA REFUGE LLC
Entity type:Organization
Organization Name:EAST CAROLINA REFUGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-903-7618
Mailing Address - Street 1:PO BOX 2104
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27894-2104
Mailing Address - Country:US
Mailing Address - Phone:252-903-7618
Mailing Address - Fax:984-960-1976
Practice Address - Street 1:319 BARNES ST S
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-5001
Practice Address - Country:US
Practice Address - Phone:252-903-7618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care