Provider Demographics
NPI:1922148477
Name:COUNTY OF ONSLOW
Entity Type:Organization
Organization Name:COUNTY OF ONSLOW
Other - Org Name:ONSLOW COUNCIL ON AGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCCOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-455-3404
Mailing Address - Street 1:328 NEW BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-4756
Mailing Address - Country:US
Mailing Address - Phone:910-455-3404
Mailing Address - Fax:910-937-1594
Practice Address - Street 1:4022 RICHLANDS HWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-8872
Practice Address - Country:US
Practice Address - Phone:910-455-2747
Practice Address - Fax:910-455-0781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600097Medicaid