Mecklenburg County

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

06240 Issued in NC

Legal business name

MECKLENBURG COUNTY

Doing business as

Mecklenburg County Health Dept - Southeast Campus

Practice address

249 Billingsley Road
Charlotte, NC 28211-1003

Phone

(980) 314-9087

Fax

(704) 432-1105

NPI assigned

Mar 9, 2011

Last updated

Feb 1, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Raynard E Washington, PHD

Title

Health Director

Phone

(980) 579-0671

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Mecklenburg County Health Dept - Southeast Campus Doing business as

Electronic endpoints 1

Tax ID family

Mecklenburg County32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

• Charlotte Cdsa

  • Public Health or Welfare Agency
  • Charlotte, NC
  • NPI 1215270715
  NPD tax ID
• Meckelnburg County

  dba Mecklenburg County Health Dept - Northwest Campus

  • Community/Retail Pharmacy
  • Charlotte, NC
  • NPI 1073893319
  NPD tax ID
• Mecklenburg County

  dba Mecklenburg County Health Department - Clinical Services

  • State or Local Public Health Clinic/Center
  • Charlotte, NC
  • NPI 1043352594
  NPD tax ID
• Mecklenburg County

  dba Mecklenburg County Health Department - CAP Services

  • Case Management Agency
  • Charlotte, NC
  • NPI 1063554517
  NPD tax ID
• Mecklenburg County

  dba Mecklenburg County Health Dept-Adult Outpatient Mental Health Services

  • State or Local Public Health Clinic/Center
  • Charlotte, NC
  • NPI 1063694222
  NPD tax ID
• Mecklenburg County

  dba Mecklenburg County Health Department - Women's Health Mammography

  • State or Local Public Health Clinic/Center
  • Charlotte, NC
  • NPI 1134261688
  NPD tax ID
• Mecklenburg County

  dba Mecklenburg County Health Dept - Northeast Campus

  • Clinic Pharmacy
  • Charlotte, NC
  • NPI 1164143996
  NPD tax ID
• Mecklenburg County

  dba Mecklenburg County Childrens Developmental Services Agency

  • Public Health or Welfare Agency
  • Charlotte, NC
  • NPI 1396814331
  NPD tax ID
• Mecklenburg County

  dba Mecklenburg County Health Department - HIV Case Management

  • Case Management Agency
  • Charlotte, NC
  • NPI 1477694313
  NPD tax ID
• Mecklenburg County

  dba Mecklenburg County Community Support Services

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1609946953
  NPD tax ID
• Mecklenburg County

  dba Mecklenburg County Health Department - MCH Case Management

  • State or Local Public Health Clinic/Center
  • Charlotte, NC
  • NPI 1619091709
  NPD tax ID
• Mecklenburg County

  dba Mecklenburg County CSS

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1619164514
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1720386188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 BILLINGSLEY ROAD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111003",
            "telephone_number": "980-314-9087",
            "fax_number": "704-432-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 BILLINGSLEY ROAD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111003",
            "telephone_number": "980-314-9087",
            "fax_number": "704-432-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECKLENBURG COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-09",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "RAYNARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "980-579-0671",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "06240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3458519",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720386188",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "na",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "249 Billingsley Road",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282111003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mecklenburg County Health Dept - Southeast Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mecklenburg County (Mecklenburg County Health Department - HIV Case Management)
• Mecklenburg County (Mecklenburg County Community Support Services)
• Mecklenburg County (Mecklenburg County Health Department - MCH Case Management)
• Mecklenburg County (Mecklenburg County CSS)
• Mecklenburg County (Mecklenburg County Dentistry)
• Mecklenburg County
• Mecklenburg County
• Mecklenburg County (Mecklenburg County Public Health Dept)
• Mecklenburg County Ambulance Service
• Mecklenburg County Area Mental Authority

• Community/Retail Pharmacy in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.