Provider Demographics
NPI:1568517746
Name:COUNTY OF WILSON
Entity Type:Organization
Organization Name:COUNTY OF WILSON
Other - Org Name:WILSON CO. HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINNAMON
Authorized Official - Middle Name:H
Authorized Official - Last Name:NARRON
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:252-291-5470
Mailing Address - Street 1:1801 GLENDALE DR SW
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4401
Mailing Address - Country:US
Mailing Address - Phone:252-291-5470
Mailing Address - Fax:252-293-8300
Practice Address - Street 1:1801 GLENDALE DR SW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4401
Practice Address - Country:US
Practice Address - Phone:252-291-5470
Practice Address - Fax:252-293-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QC1500X
261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC07194OtherBLUE CROSS BLUE SHIELD
NC3404398Medicaid
NC2803221Medicare ID - Type UnspecifiedMEDICARE
NC07194OtherBLUE CROSS BLUE SHIELD