1841248622 NPI number — COUNTY OF BRUNSWICK

Table of content: (NPI 1841248622)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841248622 NPI number — COUNTY OF BRUNSWICK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF BRUNSWICK
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:
1841248622
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOLIVIA
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28422-0009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-253-2284
Provider Business Mailing Address Fax Number:
102-532-3709

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25 COURTHOUSE DR. NE
Provider Second Line Business Practice Location Address:
BLG A
Provider Business Practice Location Address City Name:
BOLIVIA
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28422-0009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-253-2250
Provider Business Practice Location Address Fax Number:
910-253-2370
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JACKSON
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
RANDOLPH
Authorized Official Title or Position:
MANAGEMENT SUPPORT DIRECTOR
Authorized Official Telephone Number:
910-253-2284

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QC1500X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0050X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP0905X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QP2300X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , with the licence number: 34D0245906 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0002X , with the licence number: 04210 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 3404476 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 194741 . This is a "MEDCOST" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 070900 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "CAPE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 3404310 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 80888 . This is a "CIGNA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "OTHER INSURANCES" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: ========= . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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