Provider Demographics
NPI:1750405536
Name:EDGECOMBE COUNTY
Entity type:Organization
Organization Name:EDGECOMBE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING TECH II
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ANNIE
Authorized Official - Last Name:GODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-641-7952
Mailing Address - Street 1:3003 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-1922
Mailing Address - Country:US
Mailing Address - Phone:252-641-7952
Mailing Address - Fax:252-641-7980
Practice Address - Street 1:3003 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-1922
Practice Address - Country:US
Practice Address - Phone:252-641-7952
Practice Address - Fax:252-641-7980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8700030251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management