Organization
MECKLENBURG COUNTY
Active
Other names
Mecklenburg County Health Dept - Southeast Campus
Organization subpart
No
Provider details
NPI number
Authorized official
RAYNARD E WASHINGTON PHD (HEALTH DIRECTOR)
(980) 579-0671
Entity
Organization
Contact information
Practice address
249 BILLINGSLEY ROAD, CHARLOTTE, NC 28211-1003
(980) 314-9087
(704) 432-1105
Mailing address
249 BILLINGSLEY ROAD, CHARLOTTE, NC 28211-1003
(980) 314-9087
(704) 432-1105
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
06240
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720386188
—
NC
01
—
3458519
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/09/2011
Last updated
02/01/2022
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