Provider Demographics
NPI:1417924820
Name:COUNTY OF ROBESON OFFICE OF TREASURER
Entity Type:Organization
Organization Name:COUNTY OF ROBESON OFFICE OF TREASURER
Other - Org Name:ROBESON COUNTY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:IV
Authorized Official - Credentials:MPH
Authorized Official - Phone:910-671-3200
Mailing Address - Street 1:460 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28360-9494
Mailing Address - Country:US
Mailing Address - Phone:910-671-3236
Mailing Address - Fax:910-737-5012
Practice Address - Street 1:460 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28360-9494
Practice Address - Country:US
Practice Address - Phone:910-671-3236
Practice Address - Fax:910-737-5012
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF ROBESON OFFICE OF TREASUER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-03
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0526251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00778OtherBCBS
NC3407086Medicaid
NC3407086Medicaid