Provider Demographics
NPI:1184785040
Name:COUNTY OF SAMPSON
Entity type:Organization
Organization Name:COUNTY OF SAMPSON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-592-1131
Mailing Address - Street 1:360 COUNTY COMPLEX RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-4778
Mailing Address - Country:US
Mailing Address - Phone:910-592-1131
Mailing Address - Fax:910-592-1901
Practice Address - Street 1:360 COUNTY COMPLEX RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-4778
Practice Address - Country:US
Practice Address - Phone:910-592-1131
Practice Address - Fax:910-592-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Not Answered261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2803294Medicare ID - Type UnspecifiedMEDICARE MASS BILLING PN