1346379260 NPI number — PUBLIC HEALTH AUTHORITY OF CABARRUS COUNTY

Table of content: (NPI 1346379260)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346379260 NPI number — PUBLIC HEALTH AUTHORITY OF CABARRUS COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PUBLIC HEALTH AUTHORITY OF CABARRUS COUNTY
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:
1346379260
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 MOORESVILLE ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANNAPOLIS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28081-0304
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-920-1000
Provider Business Mailing Address Fax Number:
704-920-1002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 MOORESVILLE ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANNAPOLIS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28081-0304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-920-1000
Provider Business Practice Location Address Fax Number:
704-920-1002
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PILKINGTON
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
FRED
Authorized Official Title or Position:
PUBLIC HEALTH DIRECTOR, CEO
Authorized Official Telephone Number:
704-920-1000

Provider Taxonomy Codes

  • Taxonomy code: 261QC1500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QP0905X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0720G . This is a "BCBS GROUP #" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 890143P , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3404313 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3404425 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 600002631 . This is a "RAILROAD MEDICARE MASS #" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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