Provider Demographics
NPI:1518034701
Name:PERSON COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:PERSON COUNTY HEALTH DEPARTMENT
Other - Org Name:HEALTH CHOICE
Other - Org Type:Other Name
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:O
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-597-2204
Mailing Address - Street 1:355 S MADISON BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27573-5485
Mailing Address - Country:US
Mailing Address - Phone:336-597-2204
Mailing Address - Fax:336-597-4804
Practice Address - Street 1:355 S MADISON BLVD
Practice Address - Street 2:STE A
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-5485
Practice Address - Country:US
Practice Address - Phone:336-597-2204
Practice Address - Fax:336-597-4804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Not Answered261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC07102OtherHEALTH CHOICE