MEDICARE: NORTHAMPTON COUNTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HC0530	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00777	OTHER	NC	BLUE CROSS BLUE SHIELD
2	00777	OTHER	NC	STATE HEALTH PLAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356396428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHAMPTON COUNTY

Provider Business Mailing Address
First Line	:	PO BOX 635
Second Line	:
City	:	JACKSON
State	:	NC
Zip	:	27845-0635
Country	:	US
Telephone Number	:	252-534-5841
Fax Number	:	252-534-1045

Provider Business Practice Location Address
First Line	:	9495 NC 305 HIGHWAY
Second Line	:
City	:	JACKSON
State	:	NC
Zip	:	27845-0635
Country	:	US
Telephone Number	:	252-534-5841
Fax Number	:	252-534-1045

Authorized Official
Title or Position	:	HEALTH DIRECTOR
Name	:	MS. SUE G GAY
Credential	:	RN
Telephone Number	:	252-534-1291

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	06/05/2013

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Directions to “NORTHAMPTON COUNTY ” Practice Location

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