Organization
COUNTY OF BRUNSWICK
Active
Other names
Brunswick County Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BARBARA RANDOLPH JACKSON (MANAGEMENT SUPPORT DIRECTOR)
(910) 253-2284
Entity
Organization
Contact information
Practice address
25 COURTHOUSE DR. NE, BLG A, BOLIVIA, NC 28422-0009
(910) 253-2250
(910) 253-2370
Mailing address
PO BOX 9, BOLIVIA, NC 28422-0009
(910) 253-2284
(102) 532-3709
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NC
261QC1500X
Community Health Clinic/Center
—
NC
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
NC
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
NC
261QP2300X
Primary Care Clinic/Center
—
NC
291U00000X
Clinical Medical Laboratory
34D0245906
NC
3336C0002X
Clinic Pharmacy
04210
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070900
BLUE CROSS BLUE SHIELD
NC
01
—
194741
MEDCOST
NC
05
—
3404310
—
NC
05
—
3404476
—
NC
01
—
80888
CIGNA
NC
01
—
=========
CAPE
NC
Enumeration date
05/04/2006
Last updated
02/12/2024
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