1356469357 NPI number — COUNTY OF MADISON OFFICE OF AUDITOR

Table of content: (NPI 1356469357)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356469357 NPI number — COUNTY OF MADISON OFFICE OF AUDITOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF MADISON OFFICE OF AUDITOR
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:
MADISON COUNTY HEALTH DEPARTMENT-CLINICAL SERVICES
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:
1356469357
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
493 MEDICAL PARK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARSHALL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28753-3901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-649-3531
Provider Business Mailing Address Fax Number:
828-649-9078

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
493 MEDICAL PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARSHALL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28753-3901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-649-3531
Provider Business Practice Location Address Fax Number:
828-649-9078
Provider Enumeration Date:
03/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CODY
Authorized Official First Name:
TAMMY
Authorized Official Middle Name:
D
Authorized Official Title or Position:
DIRECTOR OF THE MADISON COUNTY HEAL
Authorized Official Telephone Number:
828-649-3531

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0050X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2500X ; 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" .
  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , with the licence number: 34D1053676 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0002X , with the licence number: 04201 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 3404357 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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