MEDICARE: MITCHELL COUNTY DSS

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	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871781690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MITCHELL COUNTY DSS

Provider Business Mailing Address
First Line	:	347 LONGVIEW DR
Second Line	:
City	:	BAKERSVILLE
State	:	NC
Zip	:	28705-9600
Country	:	US
Telephone Number	:	828-688-2175
Fax Number	:	828-688-4940

Provider Business Practice Location Address
First Line	:	347 LONGVIEW DR
Second Line	:
City	:	BAKERSVILLE
State	:	NC
Zip	:	28705-9600
Country	:	US
Telephone Number	:	828-688-2175
Fax Number	:	828-688-4940

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MISS PAULA HOLTSCLAW
Credential	:
Telephone Number	:	828-688-2175

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	02/20/2013

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Practice Location Address:

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Practice Location Address:

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1225060148 — JAMES BRUCE CARROLL M.D.
Practice Location Address:

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1043315054 — MOUNTAIN COMMUNITY HEALTH PARTNERSHIP INCORPORATED
Practice Location Address:

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Directions to “MITCHELL COUNTY DSS ” Practice Location

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