Organization
GRANVILLE-VANCE DISTRICT HEALTH DEPARTMENT
Active
Other names
Mass Immunizaton Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAUNA LEIGH GUTHRIE MD (MEDICAL DIRECTOR)
(919) 693-2141
Entity
Organization
Contact information
Practice address
101 HUNT ST, OXFORD, NC 27565-3414
(919) 693-2141
Mailing address
101 HUNT ST, PO BOX 367, OXFORD, NC 27565-3414
(919) 693-2141
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0721N
BCBS GRANVILLE
—
01
—
0721P
VANCE BCBS
—
05
—
3404339
—
NC
05
—
3404391
—
NC
05
—
3404416
—
NC
Enumeration date
01/26/2007
Last updated
08/20/2019
Update your record
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