Provider Demographics
NPI:1427176866
Name:COUNTY OF PAMLICO
Entity type:Organization
Organization Name:COUNTY OF PAMLICO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LOCAL HEALTH DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:252-745-5111
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:BAYBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28515-0306
Mailing Address - Country:US
Mailing Address - Phone:252-745-5111
Mailing Address - Fax:252-745-7684
Practice Address - Street 1:203 NORTH STREET
Practice Address - Street 2:
Practice Address - City:BAYBORO
Practice Address - State:NC
Practice Address - Zip Code:28515-0306
Practice Address - Country:US
Practice Address - Phone:252-745-5111
Practice Address - Fax:252-745-7684
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF PAMLICO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-26
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251B00000X, 261QC1500X, 261QF0050X, 261QM2500X, 261QP0905X, 261QP2300X
NC34D0865324291U00000X
NC049523336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251B00000XAgenciesCase Management
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No291U00000XLaboratoriesClinical Medical Laboratory
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC07211OtherBCBS
NC3404369Medicaid
NC=========OtherOTHER INSURANCE