Provider Demographics
NPI:1780759498
Name:WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION
Entity type:Organization
Organization Name:WAKE COUNTY MEDICAL SOCIETY COMMUNITY HEALTH FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-783-0404
Mailing Address - Street 1:2500 BLUE RIDGE RD
Mailing Address - Street 2:SUITE 312
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6469
Mailing Address - Country:US
Mailing Address - Phone:919-783-0404
Mailing Address - Fax:
Practice Address - Street 1:2500 BLUE RIDGE RD
Practice Address - Street 2:SUITE 312
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6469
Practice Address - Country:US
Practice Address - Phone:919-783-0404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management