Provider Demographics
NPI:1043458318
Name:COUNTY OF PAMLICO
Entity Type:Organization
Organization Name:COUNTY OF PAMLICO
Other - Org Name:PAMLICO COUNTY HEALTH DEPT. - MEDICARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:LOCAL HEALTH DIRECOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:252-745-5111
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:BAYBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28515-0306
Mailing Address - Country:US
Mailing Address - Phone:252-745-5111
Mailing Address - Fax:252-745-7684
Practice Address - Street 1:203 NORTH STREET
Practice Address - Street 2:
Practice Address - City:BAYBORO
Practice Address - State:NC
Practice Address - Zip Code:28515-0306
Practice Address - Country:US
Practice Address - Phone:252-745-5111
Practice Address - Fax:252-745-7684
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF PAMLICO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-26
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2327527Medicare PIN