Provider Demographics
NPI:1194741066
Name:COUNTY OF GRAHAM
Entity type:Organization
Organization Name:COUNTY OF GRAHAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-479-7770
Mailing Address - Street 1:12 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28771-8413
Mailing Address - Country:US
Mailing Address - Phone:828-479-7991
Mailing Address - Fax:828-479-2937
Practice Address - Street 1:12 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28771-8413
Practice Address - Country:US
Practice Address - Phone:828-479-7967
Practice Address - Fax:828-479-2937
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRAHAM COUNTY EMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-14
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14313416L0300X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406712Medicaid
NC0722GOtherBCBS
NC278028Medicare ID - Type Unspecified