Organization
GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH
Active
Parent organization
GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH
Other names
GCDPH ADULT IMMUNIZATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH
Authorized official
HARVETTE C JENKINS MD (MEDICAL DIRECTOR)
(336) 641-7777
Entity
Organization
Contact information
Practice address
501 E GREEN DR, ADULT IMMUNIZATION SERVICES, HIGH POINT, NC 27260-6707
(336) 845-7990
(336) 845-7987
Mailing address
1100 E WENDOVER AVE, ADULT IMMUNIZATION ADMINISTRATION, GREENSBORO, NC 27405-6713
(336) 647-1777
(336) 641-6971
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
291U00000X
Clinical Medical Laboratory
34D0238958
NC
291U00000X
Clinical Medical Laboratory
34D0664205
NC
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-07677
UHC
—
01
—
07124
BCBS
—
01
—
AS34604210001
CIGNA HEALTHCARE
—
Enumeration date
02/23/2007
Last updated
12/18/2008
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