Provider Demographics
NPI:1689623134
Name:COUNTY OF EDGECOMBE OFFICE OF AUDITOR
Entity Type:Organization
Organization Name:COUNTY OF EDGECOMBE OFFICE OF AUDITOR
Other - Org Name:EDGECOMBE HOMECARE & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:W
Authorized Official - Last Name:LACHAPELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-641-7531
Mailing Address - Street 1:122 E SAINT JAMES ST
Mailing Address - Street 2:PO BOX 100
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-5016
Mailing Address - Country:US
Mailing Address - Phone:252-641-7518
Mailing Address - Fax:252-641-7004
Practice Address - Street 1:122 E SAINT JAMES ST
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-5016
Practice Address - Country:US
Practice Address - Phone:252-641-7518
Practice Address - Fax:252-641-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0498251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3401581Medicaid
NC3401581Medicaid