Provider Demographics
NPI:1740217785
Name:COUNTY OF HALIFAX
Entity Type:Organization
Organization Name:COUNTY OF HALIFAX
Other - Org Name:HALIFAX COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LOCAL HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:MPA; DBA, CLC
Authorized Official - Phone:252-583-5021
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:19 NORTH DOBBS STREET
Mailing Address - City:HALIFAX
Mailing Address - State:NC
Mailing Address - Zip Code:27839-0010
Mailing Address - Country:US
Mailing Address - Phone:252-583-5021
Mailing Address - Fax:252-583-2975
Practice Address - Street 1:19 NORTH DOBBS STREET
Practice Address - Street 2:
Practice Address - City:HALIFAX
Practice Address - State:NC
Practice Address - Zip Code:27839-0010
Practice Address - Country:US
Practice Address - Phone:252-583-5021
Practice Address - Fax:252-583-2975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A251K00000X
261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC07216OtherBLUE CROSS BLUE SHIELD
NC79929OtherMEDCOST NETWORK
NC3404342Medicaid
NC6005545Medicaid
NC2270475OtherCIGNA MANAGED CARE
NC3404433Medicaid
NCE526Medicare PIN