1407995442 NPI number — COUNTY OF ONSLOW

Table of content: (NPI 1407995442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407995442 NPI number — COUNTY OF ONSLOW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF ONSLOW
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ONSLOW COUNTY HEALTH DEPT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407995442
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
328 NEW BRIDGE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28540-4756
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-455-3404
Provider Business Mailing Address Fax Number:
910-937-1594

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
612 COLLEGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28540-5311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-347-2154
Provider Business Practice Location Address Fax Number:
910-347-3165
Provider Enumeration Date:
02/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCCOLE
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
J
Authorized Official Title or Position:
FINANCE OFFICER
Authorized Official Telephone Number:
910-455-3404

Provider Taxonomy Codes

  • Taxonomy code: 261QC1500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP0905X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07172 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3404367 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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