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General NPI Number Information
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NPI Number | 1639195241
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Entity Type | Organization
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Legal Business Name | MECKLENBURG COUNTY
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 12/13/2012
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Provider Practice Location Address
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Address Line | 1801 ROZZELLES FERRY RD
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City | CHARLOTTE
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State | NC
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Zip | 28208-4228
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Country | US
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Telephone | 704-350-7305
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Fax | 704-350-7304
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Provider Business Mailing Address
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Address Line | 1801 ROZZELLES FERRY RD
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City | CHARLOTTE
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State | NC
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Zip | 28208-4228
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Country | US
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Telephone | 704-350-7305
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Fax | 704-350-7304
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Authorized Official
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Title or Position | HEALTH DIRECTOR
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Name | EARL WINTERS MABRY
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Credential | MD
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Telephone | 704-336-2299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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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 | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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