Healthcare Provider Details

I. General information

NPI: 1700917390
Provider Name (Legal Business Name): COUNTY OF CUMBERLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 01/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 EXECUTIVE PL CAP PROGRAM
FAYETTEVILLE NC
28305-5193
US

IV. Provider business mailing address

PO BOX 3069
FAYETTEVILLE NC
28302-3069
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-0601
  • Fax: 910-323-0096
Mailing address:
  • Phone: 910-323-0601
  • Fax: 910-323-0096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. DENSIE D LUCAS
Title or Position: ASSISTANT AREA DIRECTOR
Credential:
Phone: 910-323-0601