Organization
GRANVILLE-VANCE DISTRICT HEALTH DEPARTMENT
Active
Other names
Granville-Vance Home Health Agency
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILTON RODWELL DRAKE JR. MD (HEALTH DIRECTOR)
96196932141
Entity
Organization
Contact information
Practice address
125 CHARLES ROLLINS ROAD, HENDERSON, NC 27536-0000
(252) 492-5831
Mailing address
101 HUNT ST, PO BOX 367, OXFORD, NC 27565-3414
(919) 693-2141
(919) 693-8517
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251F00000X
Home Infusion Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3407062
—
NC
01
—
34D1034140
CLIA #
—
01
—
HC0501
LICENSE #
NC
Enumeration date
01/25/2007
Last updated
12/15/2011
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