1740217785 NPI number — COUNTY OF HALIFAX

Table of content: (NPI 1740217785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740217785 NPI number — COUNTY OF HALIFAX

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF HALIFAX
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:
1740217785
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/29/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HALIFAX
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27839-0010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-583-5021
Provider Business Mailing Address Fax Number:
252-583-2975

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 DOBBS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HALIFAX
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27839-7502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-583-5021
Provider Business Practice Location Address Fax Number:
252-583-2975
Provider Enumeration Date:
06/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
TALENA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATIVE OFFICER I
Authorized Official Telephone Number:
252-583-5021

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  N/A ; 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" .

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

  • Identifier: 07216 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 79929 . This is a "MEDCOST NETWORK" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 3404342 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6005545 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2270475 . This is a "CIGNA MANAGED CARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 3404433 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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