1720414980 NPI number — DURHAM COUNTY HEALTH DEPARTMENT PHARMACY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720414980 NPI number — DURHAM COUNTY HEALTH DEPARTMENT PHARMACY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DURHAM COUNTY HEALTH DEPARTMENT PHARMACY
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:
1720414980
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
414 E MAIN ST
Provider Second Line Business Mailing Address:
DURHAM COUNTY HEALTH DEPARTMENT
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-560-7632
Provider Business Mailing Address Fax Number:
919-560-7873

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
414 E MAIN ST
Provider Second Line Business Practice Location Address:
DURHAM COUNTY HEALTH DEPARTMENT
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-560-7632
Provider Business Practice Location Address Fax Number:
919-560-7873
Provider Enumeration Date:
09/19/2013

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
LAMARR
Authorized Official Title or Position:
ACCOUNTING TECHNICIAN II
Authorized Official Telephone Number:
919-560-7878

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  04685 , 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: 1457435349 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com