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NPI Code Detail

MEDICARE: MECKELNBURG COUNTY

MEDICARE: MECKELNBURG COUNTY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy06241NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23459179OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1073893319
Entity Type Code : Organization
Provider Name (Legal Business Name) : MECKELNBURG COUNTY
Provider Business Mailing Address
First Line : 2845 BEATTIES FORD RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-3711
Country : US
Telephone Number : 704-432-0343
Fax Number : 704-432-0347
Provider Business Practice Location Address
First Line : 2845 BEATTIES FORD RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-3711
Country : US
Telephone Number : 704-432-0343
Fax Number : 704-432-0347
Authorized Official
Title or Position : HEALTH DIRECTOR
Name : RAYNARD E WASHINGTON
Credential : PHD
Telephone Number : 980-579-0671
Provider Enumeration Date : 08/18/2011
Last Update Date : 02/01/2022

Similar Medicare Providers

1477694313 — MECKLENBURG COUNTY
Practice Location Address:
2845 BEATTIES FORD RD
CHARLOTTE, NC
28216-3711
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Practice Fax:
1922141340 — MRS. VIDA ABBASI WACHOB L.C.S.W
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1417083148 — JANE S FAWCETT NP
Practice Location Address:
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1477762987 — MRS. ANNE CARTER STACK LCSW
Practice Location Address:
2845 BEATTIES FORD RD
CHARLOTTE, NC
28216-3711
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1982926655 — MS. DONNA C HORTON-BOWREY RPH
Practice Location Address:
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1922627645 — NOVANT MEDICAL GROUP, INC.
Practice Location Address:
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Directions to “MECKELNBURG COUNTY ” Practice Location

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