1639382716 NPI number — MCDOWELL COUNTY

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 1639382716 NPI number — MCDOWELL COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCDOWELL 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:
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:
1639382716
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
60 E COURT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARION
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28752-4041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-652-7121
Provider Business Mailing Address Fax Number:
828-652-2983

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41 S GARDEN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARION
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28752-4024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-652-7121
Provider Business Practice Location Address Fax Number:
828-652-2983
Provider Enumeration Date:
05/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MORGAN
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
FINANCE BILLING
Authorized Official Telephone Number:
828-652-7121

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  1142 , 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: 3406764 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0723M . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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