MEDICARE: COUNTY OF DAVIDSON

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	261QC1500X	Community Health Clinic/Center
2	251B00000X	Case Management Agency
3	251K00000X	Public Health or Welfare Agency
4	261QF0050X	Non-Surgical Family Planning Clinic/Center
5	291U00000X	Clinical Medical Laboratory	34D1058572	NC
6	291U00000X	Clinical Medical Laboratory	34D0865330	NC
7	3336C0002X	Clinic Pharmacy	03861	NC
8	261QM2500X	Medical Specialty Clinic/Center
9	261QP0905X	State or Local Public Health Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	600001182	OTHER	NC	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00602	OTHER	NC	HEALTHY BLUE NC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	81671	OTHER	NC	ACNC
5	024YN	OTHER	NC	BCBS HEALTH CHOICE
6	1844	OTHER	NC	WELLCARE
7	87726	OTHER	NC	UHC-COMMUNITY PLAN
8	000042052001	OTHER	NC	UNITED HEALTH CARE

General Provider Information

NPI Number	:	1366589483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF DAVIDSON

Provider Business Mailing Address
First Line	:	915 GREENSBORO ST
Second Line	:
City	:	LEXINGTON
State	:	NC
Zip	:	27292
Country	:	US
Telephone Number	:	336-242-2300
Fax Number	:	336-242-2485

Provider Business Practice Location Address
First Line	:	915 N GREENSBORO ST
Second Line	:
City	:	LEXINGTON
State	:	NC
Zip	:	27292-2699
Country	:	US
Telephone Number	:	336-242-2300
Fax Number	:	336-242-2485

Authorized Official
Title or Position	:	HEALTH DIRECTOR
Name	:	MRS. LILLIAN KOONTZ
Credential	:	M.P.A, R.E.H.S
Telephone Number	:	336-242-2349

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	08/02/2023

Similar Medicare Providers

1083430573 — MARY EMERSON HAYES
Practice Location Address:

915 N GREENSBORO ST
LEXINGTON, NC
27292-2699

Practice Phone: 336-242-2300
Practice Fax:

1699764985 — MS. PAM O. WERSTLEIN PHD, APRN, BC, LPC
Practice Location Address:

915 N GREENSBORO ST
LEXINGTON, NC
27292-2699

Practice Phone: 336-242-2300
Practice Fax:

1841359312 — DAVIDSON COUNTY
Practice Location Address:

913 N GREENSBORO ST
LEXINGTON, NC
27292-2699

Practice Phone: 336-242-2500
Practice Fax: 336-236-3127

1437211513 — AMERICAN HUMAN SERVICES, INC.
Practice Location Address:

918 N GREENSBORO ST
LEXINGTON, NC
27292-2699

Practice Phone: 919-851-5114
Practice Fax:

1336286053 — COUNTY OF DAVIDSON
Practice Location Address:

915 N GREENSBORO ST.
LEXINGTON, NC
27292-2699

Practice Phone: 336-242-2300
Practice Fax: 336-242-2485

1205969292 — COUNTY OF DAVIDSON
Practice Location Address:

913 N GREENSBORO ST
LEXINGTON, NC
27292-2699

Practice Phone: 336-242-2029
Practice Fax: 336-243-7578

Directions to “COUNTY OF DAVIDSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.