Provider Demographics
NPI:1194858498
Name:COUNTY OF CASWELL
Entity Type:Organization
Organization Name:COUNTY OF CASWELL
Other - Org Name:CASWELL COUNTY HEALTH DEPT PERSONAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ARMSTRONG
Authorized Official - Last Name:EASTWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-694-4129
Mailing Address - Street 1:PO BOX 1238
Mailing Address - Street 2:
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379-1238
Mailing Address - Country:US
Mailing Address - Phone:336-694-4129
Mailing Address - Fax:336-694-7030
Practice Address - Street 1:189 COUNTY PARK RD.
Practice Address - Street 2:
Practice Address - City:YANCEYVILLE
Practice Address - State:NC
Practice Address - Zip Code:27379
Practice Address - Country:US
Practice Address - Phone:336-694-4129
Practice Address - Fax:336-694-7030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 261QC1500X, 261QD0000X, 261QF0050X, 261QM2500X, 261QP0905X, 261QP2300X
NC34D0865330291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251B00000XAgenciesCase Management
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0721TOtherHEALTH CHOICE AND CIGNA
NC9223880OtherCIGNA
NC211441OtherALAMANCE CNTY HEALTH PLAN
NC3404418Medicaid
NC3404317Medicaid
NC3404317Medicaid
NC=========001OtherHUMANA GOLD CHOICE
NC9223880OtherCIGNA