Provider Demographics
NPI:1720011729
Name:COUNTY OF RANDOLPH
Entity Type:Organization
Organization Name:COUNTY OF RANDOLPH
Other - Org Name:RANDOLPH COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:GEER
Authorized Official - Last Name:AKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-318-6217
Mailing Address - Street 1:2222 S FAYETTEVILLE ST STE B
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-7368
Mailing Address - Country:US
Mailing Address - Phone:336-318-6154
Mailing Address - Fax:336-636-7686
Practice Address - Street 1:2222 S FAYETTEVILLE ST STE B
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27205-7368
Practice Address - Country:US
Practice Address - Phone:336-318-6200
Practice Address - Fax:336-318-6234
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RANDOLPH COUNTY HEALTH DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-10
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
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
NC3404376Medicaid
NC0725AOtherBLUE CROSS NUMBER
NC34D0655049OtherCLIA PROVIDER ID NUMBER
NC04467OtherNORTH CAROLINA PHARMACY #
NC3404497Medicaid