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General NPI Number Information
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NPI Number | 1285624619
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Entity Type | Organization
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Legal Business Name | COUNTY OF NASH
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 200 W WASHINGTON ST
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City | NASHVILLE
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State | NC
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Zip | 27856-1264
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Country | US
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Telephone | 252-462-2687
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Fax | 252-462-2689
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Provider Business Mailing Address
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Address Line | 200 W WASHINGTON ST
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City | NASHVILLE
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State | NC
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Zip | 27856-1264
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Country | US
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Telephone | 252-462-2687
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Fax | 252-462-2689
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | MRS. MARY LOGAN BULLUCK
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Credential | RN
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Telephone | 252-462-2687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO520
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License Number State | NC
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