Provider Demographics
NPI:1679600969
Name:LENOIR COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:LENOIR COUNTY HEALTH DEPARTMENT
Other - Org Name:LENOIR COUNTY HEALTH DEPARTMENT GENERAL CLINIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-526-4212
Mailing Address - Street 1:201 N MCLEWEAN ST
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-4949
Mailing Address - Country:US
Mailing Address - Phone:252-526-4200
Mailing Address - Fax:252-527-0002
Practice Address - Street 1:201 N MCLEWEAN ST
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-4949
Practice Address - Country:US
Practice Address - Phone:252-526-4200
Practice Address - Fax:252-527-0002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF LENOIR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-27
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 261QC1500X, 261QD0000X, 261QF0050X, 261QM2500X, 261QP0905X, 261QP2300X
NC34D0865324291U00000X
NC044683336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251B00000XAgenciesCase Management
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No291U00000XLaboratoriesClinical Medical Laboratory
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0729FOtherHEALTH CHOICE BCBS
NC56162OtherMEDCOST
NC3173968OtherCIGNA
NC3404354Medicaid
NC3404354Medicaid