Provider Demographics
NPI:1952431520
Name:TOE RIVER HEALTH DISTRICT
Entity Type:Organization
Organization Name:TOE RIVER HEALTH DISTRICT
Other - Org Name:MITCHELL COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHN SUPERVISOR II
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-688-2371
Mailing Address - Street 1:130 FOREST SERVICE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BAKERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28705-7047
Mailing Address - Country:US
Mailing Address - Phone:828-688-2371
Mailing Address - Fax:828-688-3866
Practice Address - Street 1:130 FOREST SERVICE DR
Practice Address - Street 2:SUITE A
Practice Address - City:BAKERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28705-7047
Practice Address - Country:US
Practice Address - Phone:828-688-2371
Practice Address - Fax:828-688-3866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No291U00000XLaboratoriesClinical Medical Laboratory
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00198058OtherRAILROAD MEDICARE
NC34D0865328OtherCLIA
NC34D0865328OtherCLIA