County of Onslow
Organization Active NPI State or Local Public Health Clinic/Center · Jacksonville, NC
NPI 1407995442 · NPPES record last updated Oct 29, 2012
Key facts
- NPI
- 1407995442
- Entity type
- Organization (NPI type 2)
- Primary specialty
- State or Local Public Health Clinic/Center 261QP0905X
- Legal business name
- COUNTY OF ONSLOW
- Practice address
- 612 College St
Jacksonville, NC 28540-5311 - Phone
- (910) 347-2154
- Fax
- (910) 347-3165
- NPI assigned
- Feb 6, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- COUNTY OF ONSLOW
Authorized official
- Name
- Mr. David J McCole
- Title
- Finance Officer
- Phone
- (910) 455-3404
Other NPIs on the same Medicare enrollment 2
Member organizations 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031229000841 | NC | Part B Supplier - Clinic/Group Practice | 1355249343 |
Receives reassigned benefits from 6 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Jacksonville, NC |
National Provider Directory
- Part of
- County of Onslow
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | |||
| State or Local Public Health Clinic/Center | 261QP0905X | Yes |
Addresses
Primary practice location
612 College St
Jacksonville, NC 28540-5311
Mailing address
328 New Bridge St
Jacksonville, NC 28540-4756
Phone (910) 455-3404
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07172 | Other | BLUE CROSS BLUE SHIELD | |
| 3404367 | Medicaid | NC |
Other names
- Onslow County Health Dept
Other providers in Jacksonville, NC
- Asheley W Costner
- Suzette Cotter
- Taylor Rae Giglio Couch
- County of Onslow
- County of Onslow
- County of Onslow
- County of Onslow
- County of Onslow
- County of Onslow
- County of Onslow
All providers in Jacksonville, NC · State or Local Public Health Clinic/Center in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.