Provider Demographics
NPI:1972631984
Name:COUNTY OF CHATHAM
Entity Type:Organization
Organization Name:COUNTY OF CHATHAM
Other - Org Name:CHATHAM COUNTY HEALTH DEPARTMENT - HIV SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RS
Authorized Official - Phone:919-542-8215
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-0129
Mailing Address - Country:US
Mailing Address - Phone:919-542-8220
Mailing Address - Fax:919-542-8266
Practice Address - Street 1:80 EAST STREET
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312
Practice Address - Country:US
Practice Address - Phone:919-542-8220
Practice Address - Fax:919-542-8266
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF CHATHAM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-01
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8700321Medicaid