1417995309 NPI number — COUNTY OF HYDE OFFICE OF ACCOUNTANT

Table of content: (NPI 1417995309)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417995309 NPI number — COUNTY OF HYDE OFFICE OF ACCOUNTANT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF HYDE OFFICE OF ACCOUNTANT
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:
Provider Other Organization Name Type Code:
6
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:
1417995309
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 95
Provider Second Line Business Mailing Address:
1223 MAIN ST
Provider Business Mailing Address City Name:
SWAN QUARTER
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27885-1223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-926-4374
Provider Business Mailing Address Fax Number:
252-926-5739

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 OYSTER CREEK
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SWANQUARTER
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27885
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-694-3145
Provider Business Practice Location Address Fax Number:
843-765-4994
Provider Enumeration Date:
06/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
EMS DIRECTOR
Authorized Official Telephone Number:
910-340-1519

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 1223 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3406767 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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