Healthcare Provider Details

I. General information

NPI: 1669556452
Provider Name (Legal Business Name): ALBEMARLE REGIONAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 CEDAR ST
ELIZABETH CITY NC
27909-4340
US

IV. Provider business mailing address

PO BOX 189
ELIZABETH CITY NC
27907-0189
US

V. Phone/Fax

Practice location:
  • Phone: 252-338-4404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JERRY L PARKS
Title or Position: HEALTH DIRECTOR
Credential: MPH
Phone: 252-338-4404