MEDICARE: COUNTY OF ONSLOW

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	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1568448587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF ONSLOW

Provider Business Mailing Address
First Line	:	234 NW CORRIDOR BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-5309
Country	:	US
Telephone Number	:	910-455-3404
Fax Number	:	910-455-3024

Provider Business Practice Location Address
First Line	:	234 NW CORRIDOR BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-5309
Country	:	US
Telephone Number	:	910-455-3404
Fax Number	:	910-455-3024

Authorized Official
Title or Position	:	FINANCE OFFICER
Name	:	MR. DAVID J MCCOLE
Credential	:
Telephone Number	:	910-455-3404

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	10/19/2015

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Directions to “COUNTY OF ONSLOW ” Practice Location

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