Provider Demographics
NPI:1750417689
Name:BURKE COUNTY DEPARTMENT OF SOCIAL SERVICES
Entity type:Organization
Organization Name:BURKE COUNTY DEPARTMENT OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-439-2003
Mailing Address - Street 1:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-0549
Mailing Address - Country:US
Mailing Address - Phone:828-439-2003
Mailing Address - Fax:828-439-2137
Practice Address - Street 1:700 E PARKER RD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-6762
Practice Address - Country:US
Practice Address - Phone:828-439-2003
Practice Address - Fax:828-439-2137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8700009Medicaid