Healthcare Provider Details

I. General information

NPI: 1346387883
Provider Name (Legal Business Name): COUNTY OF MOORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 PINEHURST AVE.
CARTHAGE NC
28327-0279
US

IV. Provider business mailing address

705 PINEHURST AVE.
CARTHAGE NC
28327-0279
US

V. Phone/Fax

Practice location:
  • Phone: 910-947-3300
  • Fax: 910-947-5837
Mailing address:
  • Phone: 910-947-3300
  • Fax: 910-947-5837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number34D0670898
License Number StateNC
# 9
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number04804
License Number StateNC

VIII. Authorized Official

Name: MR. MATTHEW GARNER
Title or Position: INTERIM HEALTH DIRECTOR
Credential:
Phone: 910-947-3300