<Unavail>
LBN: Open Water Medical, Pa
<Unavail> is an health care organization with primary practice located at 1620 Live Oak St Ste C , Beaufort NC 28516-1582. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty.
Open Water Medical, Pa can be contacted via phone (252) 728-5737, or through Smith, Tisha Rae via phone (252) 728-5737.
Contact Information
Primary practice address
1620 Live Oak St Ste C
Beaufort NC 28516-1582
Phone: (252) 728-5737
Fax: (252) 728-5739
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X |
Profile Details
| NPI number | 1750482493 |
|---|---|
| LBN Legal business name | Open Water Medical, Pa |
| DBA Doing business as | <Unavail> |
| Authorized official | Smith, Tisha Rae |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 26th, 2006 |
| Last updated | Sep 2nd, 2025 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750482493 | NPPES |
| North Carolina | MEDICAID | 890237L | |
| North Carolina | Other | 0159M | |
| North Carolina | MEDICAID | 890159M | |
| North Carolina | Other | 0237L |
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