Provider Demographics
NPI:1467647560
Name:CHOWAN COUNTY DEPARTMENT OF SOCIAL SERVICES
Entity Type:Organization
Organization Name:CHOWAN COUNTY DEPARTMENT OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-482-1496
Mailing Address - Street 1:100 W. FREEMASON CIRCLE
Mailing Address - Street 2:
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-1870
Mailing Address - Country:US
Mailing Address - Phone:252-482-7441
Mailing Address - Fax:252-482-7041
Practice Address - Street 1:100 W. FREEMASON CIRCLE
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-1870
Practice Address - Country:US
Practice Address - Phone:252-482-7441
Practice Address - Fax:252-482-7041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8700057Medicaid