Healthcare Provider Details

I. General information

NPI: 1194803437
Provider Name (Legal Business Name): COUNTY OF ROWAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 12/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 E INNES ST
SALISBURY NC
28146-6030
US

IV. Provider business mailing address

1811 E INNES ST
SALISBURY NC
28146-6030
US

V. Phone/Fax

Practice location:
  • Phone: 704-216-8777
  • Fax: 704-638-3129
Mailing address:
  • Phone: 704-216-8777
  • Fax: 704-638-3129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number34D0672502
License Number StateNC
# 8
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number04190
License Number StateNC

VIII. Authorized Official

Name: MS. NINA M. OLIVER
Title or Position: INTERIM HEALTH DIRECTOR
Credential: MS
Phone: 704-216-8871