1588232953 NPI number — NC CHILDHOOD LEAD POISONING PREVENTION PROGRAM

Table of content: MR. JAMES E. LATTA DDS (NPI 1659312767)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588232953 NPI number — NC CHILDHOOD LEAD POISONING PREVENTION PROGRAM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NC CHILDHOOD LEAD POISONING PREVENTION PROGRAM
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:
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:
1588232953
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1632 MAIL SERVICE CTR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27699-1632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-707-5950
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5605 SIX FORKS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27609-3811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-707-5950
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2021

Additional Information

Authorized Official

Authorized Official Last Name:
NAPIER
Authorized Official First Name:
MELANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
PUBLIC HEALTH EPIDEMIOLOGIST
Authorized Official Telephone Number:
919-407-9401

Provider Taxonomy Codes

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

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





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