Provider Demographics
NPI:1023174711
Name:NORTHAMPTON COUNTY
Entity type:Organization
Organization Name:NORTHAMPTON COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:G
Authorized Official - Last Name:GAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:252-534-5841
Mailing Address - Street 1:PO BOX 635
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NC
Mailing Address - Zip Code:27845-0635
Mailing Address - Country:US
Mailing Address - Phone:252-534-5841
Mailing Address - Fax:252-534-1045
Practice Address - Street 1:9495 NC 305 HIGHWAY
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NC
Practice Address - Zip Code:27845-0635
Practice Address - Country:US
Practice Address - Phone:252-534-5841
Practice Address - Fax:252-534-1045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251B00000XAgenciesCase Management
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No291U00000XLaboratoriesClinical Medical Laboratory
No3336C0002XSuppliersPharmacyClinic Pharmacy
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3404366Medicaid
NC1306972278OtherBLUE CROSS BLUE SHIELD
NC3404366Medicaid
NC=========OtherTAX ID