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General NPI Number Information
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NPI Number | 1548391972
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Entity Type | Organization
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Legal Business Name | COUNTY OF BRUNSWICK
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 11/12/2013
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Provider Practice Location Address
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Address Line | 60 GOVERNMENT CENTER DRIVE
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City | BOLIVIA
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State | NC
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Zip | 28422-0219
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Country | US
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Telephone | 910-253-2077
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Fax | 910-253-2071
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Provider Business Mailing Address
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Address Line | PO BOX 219
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City | BOLIVIA
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State | NC
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Zip | 28422-0219
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Country | US
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Telephone | 910-253-2077
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Fax | 910-253-2071
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Authorized Official
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Title or Position | DIRECTOR
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Name | CATHERINE LYTCH
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Credential |
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Telephone | 910-253-2080
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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 | HC1057
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License Number State | NC
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