Provider Demographics
NPI:1447253620
Name:COUNTY OF WARREN
Entity type:Organization
Organization Name:COUNTY OF WARREN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HOME HEALTH SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRTHOLOMEW
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:252-257-4081
Mailing Address - Street 1:544 W RIDGEWAY ST
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27589-1716
Mailing Address - Country:US
Mailing Address - Phone:252-257-4081
Mailing Address - Fax:
Practice Address - Street 1:544 W RIDGEWAY ST
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:NC
Practice Address - Zip Code:27589-1716
Practice Address - Country:US
Practice Address - Phone:252-257-4081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF WARREN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-05-23
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0341251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0078BOtherBLUE CROSS/BLUE SHIELD
NC3407119Medicaid
NC34-7119Medicare ID - Type Unspecified