Provider Demographics
NPI:1558605287
Name:PAMLICO COUNTY DEPARTMENT OF SOCIAL SERVICES
Entity Type:Organization
Organization Name:PAMLICO COUNTY DEPARTMENT OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-745-4086
Mailing Address - Street 1:828 ALLIANCE MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAYBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28515-9419
Mailing Address - Country:US
Mailing Address - Phone:252-745-4086
Mailing Address - Fax:252-745-7394
Practice Address - Street 1:828 ALLIANCE MAIN ST
Practice Address - Street 2:
Practice Address - City:BAYBORO
Practice Address - State:NC
Practice Address - Zip Code:28515-9419
Practice Address - Country:US
Practice Address - Phone:252-745-4086
Practice Address - Fax:252-745-7394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1165253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care