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NPI Code Detail

MEDICARE: MARTIN-TYRRELL-WASHINGOTN DISTRICT HEALTH DEPARTMENT

MEDICARE: MARTIN-TYRRELL-WASHINGOTN DISTRICT HEALTH DEPARTMENT
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
1251E00000XHome Health AgencyNC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306919139
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARTIN-TYRRELL-WASHINGOTN DISTRICT HEALTH DEPARTMENT
Provider Business Mailing Address
First Line : 198 NC HIGHWAY 45 N
Second Line :
City : PLYMOUTH
State : NC
Zip : 27962-9232
Country : US
Telephone Number : 252-793-3023
Fax Number :
Provider Business Practice Location Address
First Line : 243 GREEN ST
Second Line :
City : WILLIAMSTON
State : NC
Zip : 27892-2000
Country : US
Telephone Number : 252-793-3023
Fax Number :
Authorized Official
Title or Position : HOME CARE DIRECTOR
Name : KATHERINE DAVIS
Credential :
Telephone Number : 252-791-3152
Provider Enumeration Date : 11/17/2006
Last Update Date : 04/03/2009

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Directions to “MARTIN-TYRRELL-WASHINGOTN DISTRICT HEALTH DEPARTMENT ” Practice Location

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