Provider Demographics
NPI:1174654461
Name:ROBESON COUNTY JAIL HEALTH SERVICE
Entity Type:Organization
Organization Name:ROBESON COUNTY JAIL HEALTH SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ENID
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:BEGAY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:910-671-3280
Mailing Address - Street 1:122 LEGEND RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-8936
Mailing Address - Country:US
Mailing Address - Phone:910-671-3280
Mailing Address - Fax:910-671-3286
Practice Address - Street 1:122 LEGEND RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-8936
Practice Address - Country:US
Practice Address - Phone:910-671-3280
Practice Address - Fax:910-671-3286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health