Healthcare Provider Details

I. General information

NPI: 1164133682
Provider Name (Legal Business Name): MECKLENBURG COUNTY BOARD OF SUPERVISORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2022
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 WASHINGTON ST
BOYDTON VA
23917-2257
US

IV. Provider business mailing address

PO BOX 70
WARSAW VA
22572-0070
US

V. Phone/Fax

Practice location:
  • Phone: 804-333-4593
  • Fax: 804-333-4614
Mailing address:
  • Phone: 804-333-4593
  • Fax: 804-333-4614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY KAY BAUGHAN
Title or Position: BILLING MANAGER
Credential:
Phone: 804-333-4593