Provider Demographics
NPI:1821159146
Name:COUNTY OF CASWELL
Entity Type:Organization
Organization Name:COUNTY OF CASWELL
Other - Org Name:CASWELL COUNTY HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ARMSTRONG
Authorized Official - Last Name:EASTWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-694-4129
Mailing Address - Street 1:189 COUNTY PARK RD
Mailing Address - Street 2:
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379
Mailing Address - Country:US
Mailing Address - Phone:336-694-9592
Mailing Address - Fax:336-694-7450
Practice Address - Street 1:189 COUNTY PARK RD
Practice Address - Street 2:
Practice Address - City:YANCEYVILLE
Practice Address - State:NC
Practice Address - Zip Code:27379
Practice Address - Country:US
Practice Address - Phone:336-694-9592
Practice Address - Fax:336-694-7450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0489251E00000X
NC34D1035350291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC0489OtherHOME HEALTH LICENSE NO.
NC3407175Medicaid
NC0071EOtherBC BS
NC0071EOtherBC BS
NC=========OtherCOUNTY TAX ID