Provider Demographics
NPI:1962405159
Name:COUNTY OF HYDE OFFICE OF ACCOUNTANT
Entity type:Organization
Organization Name:COUNTY OF HYDE OFFICE OF ACCOUNTANT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LUANA
Authorized Official - Middle Name:CARAWAN
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-926-4387
Mailing Address - Street 1:1151 MAIN STREET
Mailing Address - Street 2:PO BOX 100
Mailing Address - City:SWANQUARTER
Mailing Address - State:NC
Mailing Address - Zip Code:27885-0100
Mailing Address - Country:US
Mailing Address - Phone:252-926-4200
Mailing Address - Fax:252-926-3702
Practice Address - Street 1:1151 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SWANQUARTER
Practice Address - State:NC
Practice Address - Zip Code:27885-0100
Practice Address - Country:US
Practice Address - Phone:252-926-4200
Practice Address - Fax:252-926-3702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
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
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No291U00000XLaboratoriesClinical Medical Laboratory
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC07213OtherBCBS
NC3404348Medicaid
NC34DO865324OtherCLIA LICENSE
NC34DO865324OtherCLIA LICENSE
NC34DO865324OtherCLIA LICENSE