Provider Demographics
NPI:1770645319
Name:COUNTY OF YADKIN
Entity Type:Organization
Organization Name:COUNTY OF YADKIN
Other - Org Name:YADKIN COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:B
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:336-679-4203
Mailing Address - Street 1:217 E. WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-0457
Mailing Address - Country:US
Mailing Address - Phone:336-679-4203
Mailing Address - Fax:336-679-6358
Practice Address - Street 1:217 E. WILLOW ST
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055-0457
Practice Address - Country:US
Practice Address - Phone:336-679-4203
Practice Address - Fax:336-679-6358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QF0050X, 261QM2500X, 261QP0905X, 291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Not Answered261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Not Answered261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Not Answered291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3404460Medicaid