Healthcare Provider Details

I. General information

NPI: 1922148477
Provider Name (Legal Business Name): COUNTY OF ONSLOW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 10/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4022 RICHLANDS HWY
JACKSONVILLE NC
28540-8872
US

IV. Provider business mailing address

328 NEW BRIDGE ST
JACKSONVILLE NC
28540-4756
US

V. Phone/Fax

Practice location:
  • Phone: 910-455-2747
  • Fax: 910-455-0781
Mailing address:
  • Phone: 910-455-3404
  • Fax: 910-937-1594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID J MCCOLE
Title or Position: FINANCE OFFICER
Credential:
Phone: 910-455-3404