1417995309 NPI number — COUNTY OF HYDE OFFICE OF ACCOUNTANT

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 1417995309 NPI number — COUNTY OF HYDE OFFICE OF ACCOUNTANT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF HYDE OFFICE OF ACCOUNTANT
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:
1417995309
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 95
Provider Second Line Business Mailing Address:
1223 MAIN ST
Provider Business Mailing Address City Name:
SWAN QUARTER
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27885-1223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-926-4374
Provider Business Mailing Address Fax Number:
252-926-5739

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 OYSTER CREEK
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SWANQUARTER
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27885
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-694-3145
Provider Business Practice Location Address Fax Number:
843-765-4994
Provider Enumeration Date:
06/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
EMS DIRECTOR
Authorized Official Telephone Number:
910-340-1519

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 1223 , 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: 3406767 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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