Provider Demographics
NPI:1407995442
Name:COUNTY OF ONSLOW
Entity Type:Organization
Organization Name:COUNTY OF ONSLOW
Other - Org Name:ONSLOW COUNTY HEALTH DEPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCCOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-455-3404
Mailing Address - Street 1:328 NEW BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-4756
Mailing Address - Country:US
Mailing Address - Phone:910-455-3404
Mailing Address - Fax:910-937-1594
Practice Address - Street 1:612 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-5311
Practice Address - Country:US
Practice Address - Phone:910-347-2154
Practice Address - Fax:910-347-3165
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF ONSLOW
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-06
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
07172OtherBLUE CROSS BLUE SHIELD
NC3404367Medicaid
CJ8100Medicare ID - Type UnspecifiedRAILROAD
07172OtherBLUE CROSS BLUE SHIELD