Healthcare Provider Details

I. General information

NPI: 1275958589
Provider Name (Legal Business Name): GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2014
Last Update Date: 02/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 MAPLE ST
GREENSBORO NC
27405-6910
US

IV. Provider business mailing address

1203 MAPLE ST
GREENSBORO NC
27405-6910
US

V. Phone/Fax

Practice location:
  • Phone: 336-641-3809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHC0511
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MERLE GREEN
Title or Position: HEALTH DIRECTOR
Credential:
Phone: 336-641-3288