Provider Demographics
NPI:1558419986
Name:ROWAN COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:ROWAN COUNTY HEALTH DEPARTMENT
Other - Org Name:CLIA LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM HEALTH DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:704-216-8871
Mailing Address - Street 1:1811 E INNES ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-6030
Mailing Address - Country:US
Mailing Address - Phone:704-216-8777
Mailing Address - Fax:704-638-3129
Practice Address - Street 1:1811 E INNES ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-6030
Practice Address - Country:US
Practice Address - Phone:704-216-8777
Practice Address - Fax:704-638-3129
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF ROWAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-08
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP0905X
NC34D0672502291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC07231OtherBLUECROSSBLUESHIELD OF NC
NC=========OtherPRIMARY PHYSICIAN CARE
NC07231OtherBLUECROSSBLUESHIELD OF NC
NC=========OtherPRIMARY PHYSICIAN CARE