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NPI 1306919139

NPI 1306919139 : MARTIN-TYRRELL-WASHINGOTN DISTRICT HEALTH DEPARTMENT : WILLIAMSTON, NC

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General NPI Number Information
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    NPI Number           |    1306919139
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    Entity Type          |    Organization 
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    Legal Business Name  |    MARTIN-TYRRELL-WASHINGOTN DISTRICT HEALTH DEPARTMENT 
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Dates
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    Enumeration Date     |    11/17/2006
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    Last Update Date     |    04/03/2009
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Provider Practice Location Address
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    Address Line         |    243 GREEN ST 
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    City                 |    WILLIAMSTON
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    State                |    NC
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    Zip                  |    27892-2000
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    Country              |    US
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    Telephone            |    252-793-3023
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    198 NC HIGHWAY 45 N 
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    City                 |    PLYMOUTH
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    State                |    NC
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    Zip                  |    27962-9232
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    Country              |    US
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    Telephone            |    252-793-3023
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    Fax                  |    
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Authorized Official
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    Title or Position    |    HOME CARE DIRECTOR
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    Name                 |     KATHERINE  DAVIS 
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    Credential           |    
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    Telephone            |    252-791-3152
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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       |    
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    License Number State |    NC
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