=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134268634
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ORANGE COUNTY DEPARTMENT OF SOCIAL SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2007
-----------------------------------------------------
Last Update Date | 07/15/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 W TRYON ST
-----------------------------------------------------
City | HILLSBOROUGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27278-2438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-245-2811
-----------------------------------------------------
Fax | 919-644-3005
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 8181 300 W. TRYON STREET
-----------------------------------------------------
City | HILLSBOROUGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27278-8181
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-245-2815
-----------------------------------------------------
Fax | 919-644-3005
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | NANCY COSTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 919-245-2802
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------