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General NPI Number Information
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NPI Number | 1356540637
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Entity Type | Organization
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Legal Business Name | PENDER COUNTY DEPT OF SOCIAL SERVICES
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 810 S WALKER ST
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City | BURGAW
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State | NC
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Zip | 28425-5000
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Country | US
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Telephone | 910-259-1240
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Fax | 910-259-1418
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Provider Business Mailing Address
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Address Line | 810 S WALKER ST
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City | BURGAW
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State | NC
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Zip | 28425-5000
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Country | US
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Telephone | 910-259-1240
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Fax | 910-259-1418
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. RETA M SHIVER
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Credential | D.P.A.
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Telephone | 910-259-1240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HC0694
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License Number State | NC
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