Healthcare Provider Details

I. General information

NPI: 1053619072
Provider Name (Legal Business Name): GRANVILLE HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 COLLEGE ST
OXFORD NC
27565-2507
US

IV. Provider business mailing address

PO BOX 947
OXFORD NC
27565-0947
US

V. Phone/Fax

Practice location:
  • Phone: 919-690-8413
  • Fax: 919-603-1097
Mailing address:
  • Phone: 919-690-8413
  • Fax: 919-603-1097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL002146
License Number StateNC

VIII. Authorized Official

Name: MELANIE HOBGOOD
Title or Position: ACTING CEO
Credential:
Phone: 919-690-3445