Healthcare Provider Details

I. General information

NPI: 1447253620
Provider Name (Legal Business Name): COUNTY OF WARREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 06/04/2021
Certification Date: 06/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

544 W RIDGEWAY ST
WARRENTON NC
27589-1716
US

IV. Provider business mailing address

544 W RIDGEWAY ST
WARRENTON NC
27589-1716
US

V. Phone/Fax

Practice location:
  • Phone: 252-257-4081
  • Fax:
Mailing address:
  • Phone: 252-257-4081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC0341
License Number StateNC

VIII. Authorized Official

Name: MS. SHARON BARRTHOLOMEW
Title or Position: HOME HEALTH SUPERVISOR
Credential: RN
Phone: 252-257-4081