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General NPI Number Information
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NPI Number | 1275689242
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Entity Type | Organization
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Legal Business Name | GRANVILLE-VANCE DISTRICT HEALTH DEPARTMENT
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 12/15/2011
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Provider Practice Location Address
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Address Line | 125 CHARLES ROLLINS ROAD
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City | HENDERSON
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State | NC
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Zip | 27536-0000
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Country | US
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Telephone | 252-492-5831
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Fax |
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Provider Business Mailing Address
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Address Line | 101 HUNT ST PO BOX 367
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City | OXFORD
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State | NC
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Zip | 27565-3414
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Country | US
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Telephone | 919-693-2141
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Fax | 919-693-8517
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Authorized Official
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Title or Position | HEALTH DIRECTOR
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Name | DR. WILTON RODWELL DRAKE JR.
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Credential | MD
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Telephone | 96196932141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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