Healthcare Provider Details

I. General information

NPI: 1871594622
Provider Name (Legal Business Name): COUNTY OF WAYNE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 CLINGMAN ST
GOLDSBORO NC
27534-2162
US

IV. Provider business mailing address

1560 CLINGMAN ST
GOLDSBORO NC
27534-2162
US

V. Phone/Fax

Practice location:
  • Phone: 919-731-1000
  • Fax: 373-705-6546
Mailing address:
  • Phone: 919-731-1000
  • Fax: 919-705-6546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number7221
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number7221
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number7221
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number7221
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number7221
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number7221
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number03873
License Number StateNC

VIII. Authorized Official

Name: DAWN KAUPA
Title or Position: MEDICAL RECORDS MANAGER
Credential:
Phone: 919-731-1284