Provider Demographics
NPI:1770637381
Name:DARE COUNTY ADMINISTRATIVE OFFICES
Entity Type:Organization
Organization Name:DARE COUNTY ADMINISTRATIVE OFFICES
Other - Org Name:DARE COUNTY DEPARTMENT OF PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:B
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MPH
Authorized Official - Phone:252-475-5003
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:MANTEO
Mailing Address - State:NC
Mailing Address - Zip Code:27954-1000
Mailing Address - Country:US
Mailing Address - Phone:252-475-5003
Mailing Address - Fax:252-473-2153
Practice Address - Street 1:109 EXETER ST
Practice Address - Street 2:
Practice Address - City:MANTEO
Practice Address - State:NC
Practice Address - Zip Code:27954-9400
Practice Address - Country:US
Practice Address - Phone:252-475-5003
Practice Address - Fax:252-473-2153
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DARE COUNTY ADMINISTRATIVE OFFICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-22
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 261QC1500X, 261QD0000X, 261QF0050X, 261QM1300X, 261QP0905X, 261QP2300X
NC34D0865324291U00000X
NC048343336C0002X
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
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No291U00000XLaboratoriesClinical Medical Laboratory
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2106582OtherMAMSI PROVIDER NUMBER
NC0721GOtherBCBS PROVIDER NUMBER
NC3404328Medicaid
NC0721GOtherBCBS PROVIDER NUMBER
NC0721GOtherBCBS PROVIDER NUMBER