1144340043 NPI number — COUNTY OF NASH

Table of content: (NPI 1144340043)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144340043 NPI number — COUNTY OF NASH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF NASH
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:
NASH COUNTY HEALTH DEPARTMENT CAP
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:
1144340043
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 849
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27856-0849
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-459-1238
Provider Business Mailing Address Fax Number:
252-459-9834

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
214 S BARNES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27856-1204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-462-2743
Provider Business Practice Location Address Fax Number:
252-459-8540
Provider Enumeration Date:
04/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LEE
Authorized Official First Name:
SHANNON
Authorized Official Middle Name:
RACKLEY
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
252-459-1238

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC0520 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 3408150 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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