Provider Demographics
NPI:1013272400
Name:NORTH CAROLINA A&T STATE UNIVERSITY
Entity Type:Organization
Organization Name:NORTH CAROLINA A&T STATE UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS AND FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:POMPEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-334-7587
Mailing Address - Street 1:913 BLUFORD STREET
Mailing Address - Street 2:CENTER FOR BEHAVIORAL HEALTH AND WELLNESS
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-3121
Mailing Address - Country:US
Mailing Address - Phone:336-285-2605
Mailing Address - Fax:336-285-2607
Practice Address - Street 1:913 BLUFORD ST
Practice Address - Street 2:CENTER FOR BEHAVIORAL HEALTH AND WELLNESS
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-3121
Practice Address - Country:US
Practice Address - Phone:336-285-2605
Practice Address - Fax:336-285-2607
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH CAROLINA A&T STATE UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health