Provider Demographics
NPI:1447237367
Name:COUNTY OF GRANVILLE
Entity type:Organization
Organization Name:COUNTY OF GRANVILLE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COUNTY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALLIGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-603-1311
Mailing Address - Street 1:PO BOX 1642
Mailing Address - Street 2:145 WILLIAMSBORO STREET
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-1642
Mailing Address - Country:US
Mailing Address - Phone:919-603-1339
Mailing Address - Fax:919-693-4231
Practice Address - Street 1:1040 COLLEGE ST EXT
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-1642
Practice Address - Country:US
Practice Address - Phone:919-690-0471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-30
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC03901293416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406972Medicaid
NC3406972Medicaid