1427183813 NPI number — GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH

Table of content: (NPI 1427183813)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427183813 NPI number — GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
GCDPH LAB SERVICES
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427183813
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 E WENDOVER AVE
Provider Second Line Business Mailing Address:
LAB ADMINISTRATION
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27405-6713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-641-7777
Provider Business Mailing Address Fax Number:
336-641-6971

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 E GREEN DR
Provider Second Line Business Practice Location Address:
LAB SERVICES
Provider Business Practice Location Address City Name:
HIGH POINT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27260-6707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-845-7990
Provider Business Practice Location Address Fax Number:
336-845-7987
Provider Enumeration Date:
02/23/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JENKINS
Authorized Official First Name:
HARVETTE
Authorized Official Middle Name:
C
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
336-641-7777

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 261QP0905X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336C0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 291U00000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 291U00000X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07124 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: AS34604210001 . This is a "CIGNA HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01-07677 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".