| NPI | 1164557567 |
|---|---|
| Other Name | GCDPH ADULT IMMUNIZATION |
| Entity Type | Organization |
| Authorized Contact | HARVETTE C JENKINS Medical Director 336-641-7777 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 291U00000X Clinical Medical Laboratory (Licence: NC 34D0238958) | |
| 291U00000X Clinical Medical Laboratory (Licence: NC 34D0664205) | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2008-12-18 |