1619003605 NPI number — COUNTY OF CALDWELL

Table of content: (NPI 1619003605)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619003605 NPI number — COUNTY OF CALDWELL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF CALDWELL
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:
CALDWELL CO. HEALTH DEPT.- CBRS
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:
1619003605
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2345 MORGANTON BLVD SUITE B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LENOIR
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28645-5311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-426-8400
Provider Business Mailing Address Fax Number:
828-426-8450

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2345 MORGANTON BLVD SW STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LENOIR
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28645-4973
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-426-8400
Provider Business Practice Location Address Fax Number:
828-426-8450
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MICHAUD
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
HEALTH DIRECTOR
Authorized Official Telephone Number:
828-426-8415

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 8300175 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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