Provider Demographics
NPI:1083756571
Name:COUNTY OF CALDWELL
Entity Type:Organization
Organization Name:COUNTY OF CALDWELL
Other - Org Name:CALDWELL COUNTY HEALTH DEPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:N
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-426-8415
Mailing Address - Street 1:2345 MORGANTON BLVD SW
Mailing Address - Street 2:SUITE B
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-4973
Mailing Address - Country:US
Mailing Address - Phone:828-426-8400
Mailing Address - Fax:828-426-8450
Practice Address - Street 1:2345 MORGANTON BLVD SW
Practice Address - Street 2:SUITE B
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-4973
Practice Address - Country:US
Practice Address - Phone:828-426-8400
Practice Address - Fax:828-426-8450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF CALDWELL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-13
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251S00000X, 261QC1500X, 261QD0000X, 261QF0050X, 261QM2500X, 261QP0905X, 261QP2300X
NC34D0690973291U00000X
NC101133336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No291U00000XLaboratoriesClinical Medical Laboratory
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2411319OtherCIGNA
NC07065OtherBLUECROSSBLUESHIELD
NC3404464Medicaid
NC6906OtherUNITED HEALTH CARE
NC34D0690973OtherCLIA ID NUMBER
NC56162OtherMED COST
NC6906OtherUNITED HEALTH CARE
NC=========002OtherTRICARE
0310Medicare PIN