Provider Demographics
NPI:1942349519
Name:COUNTY OF STANLY
Entity Type:Organization
Organization Name:COUNTY OF STANLY
Other - Org Name:STANLY CO HLTH DEPT - MASS IMMUNIZATION
Other - Org Type:Other Name
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:JOYNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-982-9171
Mailing Address - Street 1:1000 N 1ST ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-2819
Mailing Address - Country:US
Mailing Address - Phone:704-982-9171
Mailing Address - Fax:704-982-8354
Practice Address - Street 1:1000 N 1ST ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-2819
Practice Address - Country:US
Practice Address - Phone:704-982-9171
Practice Address - Fax:704-982-8354
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF STANLY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-06
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QC1500X, 261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========OtherOTHER INSURANCE
NC=========OtherOTHER INSURANCE