Provider Demographics
NPI:1356469357
Name:COUNTY OF MADISON OFFICE OF AUDITOR
Entity Type:Organization
Organization Name:COUNTY OF MADISON OFFICE OF AUDITOR
Other - Org Name:MADISON COUNTY HEALTH DEPARTMENT-CLINICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF THE MADISON COUNTY HEAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:D
Authorized Official - Last Name:CODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-649-3531
Mailing Address - Street 1:493 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-3901
Mailing Address - Country:US
Mailing Address - Phone:828-649-3531
Mailing Address - Fax:828-649-9078
Practice Address - Street 1:493 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-3901
Practice Address - Country:US
Practice Address - Phone:828-649-3531
Practice Address - Fax:828-649-9078
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF MADISON OFFICE OF AUDITOR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-27
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QD0000X, 261QF0050X, 261QM2500X, 261QP0905X, 261QP2300X
NC34D1053676291U00000X
NC042013336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
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
NC3404357Medicaid
NC3404357Medicaid