Healthcare Provider Details

I. General information

NPI: 1386646552
Provider Name (Legal Business Name): COUNTY OF CALDWELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 06/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 MORGANTON BLVD SW
LENOIR NC
28645-4973
US

IV. Provider business mailing address

2345 MORGANTON BLVD SW
LENOIR NC
28645-4973
US

V. Phone/Fax

Practice location:
  • Phone: 828-426-8401
  • Fax: 828-426-8441
Mailing address:
  • Phone: 828-426-8401
  • Fax: 828-426-8441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC0487
License Number StateNC

VIII. Authorized Official

Name: MRS. VALERIE CLARK KELLY
Title or Position: HOME HEALTH DIRECTOR
Credential: CRNI
Phone: 828-426-8438