| Details | Last Recertification Date | Update | Recertification | 5/8/2024 8:38:52 AM | 5/5/2025 8:37:32 AM | 5/5/2025 8:37 AM |
| Details | Last Recertification Date | Update | Recertification | 5/9/2023 9:05:49 AM | 5/8/2024 8:38:52 AM | 5/8/2024 8:38 AM |
| Details | Nature of Support: Support Received To Date | Update | Change Request | 12/31/2023 12:00:00 AM | 1/31/2026 12:00:00 AM | 2/9/2024 1:58 PM |
| Contacts | Primary Contact | Update | Change Request | Bulluck, Valerie Michelle
PHN Director of Nursing II
Wilson County Health Department
2522373141-6749 | Dixon, Jennifer Bradbury
Director of Nursing
Wilson County Health Department
2522373141-6693 | 5/31/2023 6:43 AM |
| Details | Last Recertification Date | Update | Recertification | 5/11/2022 7:35:54 AM | 5/9/2023 9:05:49 AM | 5/9/2023 9:05 AM |
| Contacts | Authorizing Official | Update | AO Change Request | Ellen, Teresa
Health Director
Wilson County Health Department
2522915470 | Narron, Cinnamon Hales
Health Director
Wilson County Health Department
2522915470-6271 | 5/8/2023 2:43 PM |
| Details | Last Recertification Date | Update | Recertification | 5/4/2021 8:33:32 AM | 5/11/2022 7:35:54 AM | 5/11/2022 7:35 AM |
| Details | Grant Number | Update | Change Request | 5 NH25PS005152-03-00 | 5 NH25PS005152-04-00 | 5/4/2022 9:28 AM |
| Details | Nature of Support: Support Received From Date | Update | Recertification | | 1/1/2019 12:00:00 AM | 5/4/2021 8:33 AM |
| Details | Nature of Support: Support Received To Date | Update | Recertification | | 12/31/2023 12:00:00 AM | 5/4/2021 8:33 AM |
| Details | Last Recertification Date | Update | Recertification | 5/6/2020 11:29:33 AM | 5/4/2021 8:33:32 AM | 5/4/2021 8:33 AM |
| Details | Grant Number | Update | Recertification | 5NH25PS005152 | 5 NH25PS005152-03-00 | 5/4/2021 8:33 AM |
| Details | NOFO Number | Update | Recertification | | CDC-RFA-PS19-1901 | 5/4/2021 8:33 AM |
| Details | Grant Number | Update | Change Request | 1NU52PS910218-01 | 5NH25PS005152 | 4/23/2021 11:01 AM |
| Details | Last Recertification Date | Update | Recertification | 5/13/2019 8:07:31 AM | 5/6/2020 11:29:33 AM | 5/6/2020 11:29 AM |
| Details | Grant Number | Update | Recertification | 1NH25PS005152-01 | 1NU52PS910218-01 | 5/6/2020 11:29 AM |
| Details | Last Recertification Date | Update | Recertification | 5/1/2018 4:24:47 PM | 5/13/2019 8:07:31 AM | 5/13/2019 8:07 AM |
| Addresses | Main Address | Update | Change Request |
1801 GLENDALE DRIVE
WILSON, NC 27893 |
1801 GLENDALE DRIVE SW
WILSON, NC 27893 | 2/27/2019 7:47 PM |
| Details | Grant Number | Update | Change Request | STD-NC | 1NH25PS005152-01 | 2/27/2019 7:47 PM |
| Details | Last Recertification Date | Update | Recertification | 5/1/2017 12:00:00 AM | 5/1/2018 4:24:47 PM | 5/1/2018 4:24 PM |
| Contacts | Authorizing Official | Update | | Ellen, Teresa
Health Director
2522915470 | Ellen, Teresa
Health Director
Wilson County Health Department
2522915470 | 5/1/2018 4:21 PM |
| Contacts | Primary Contact | Update | | Bulluck, Valerie
PHN Director of Nursing II
2522373141-6749 | Bulluck, Valerie Michelle
PHN Director of Nursing II
Wilson County Health Department
2522373141-6749 | 1/24/2018 1:16 PM |
| Contacts | Authorizing Official | Update | | Williford, Ellis
Interim Health Director
2522373141-6276 | Ellen, Teresa
Health Director
2522915470 | 5/4/2017 7:53 AM |
| Contacts | Primary Contact | Update | | Morrison, Tammra
PHN Supervisor I
2522373141-6751 | Bulluck, Valerie
PHN Director of Nursing II
2522373141-6749 | 5/4/2017 7:53 AM |
| Addresses | Main Address | Insert | | |
1801 GLENDALE DRIVE
WILSON, NC 27893 | 5/1/2017 10:24 AM |
| Details | Last Recertification Date | Update | | 2/22/2016 12:00:00 AM | 5/1/2017 12:00:00 AM | 5/1/2017 10:24 AM |
| Details | Last Recertification Date | Update | | 2/9/2015 12:00:00 AM | 2/22/2016 12:00:00 AM | 2/22/2016 9:52 AM |
| Details | Nature Of Support | Insert | | | Direct Funding (dollars received from CDC or an intermediate organization) | 2/9/2015 10:29 AM |
| Details | Last Recertification Date | Update | | 2/12/2014 12:00:00 AM | 2/9/2015 12:00:00 AM | 2/9/2015 10:29 AM |
| Contacts | Primary Contact | Update | | HANCOCK, KRISTEN
PHA NC STD DRUG PROGRAM
9197332030-204 | Morrison, Tammra
PHN Supervisor I
2522373141-6751 | 4/22/2014 8:54 AM |
| Details | Last Recertification Date | Update | | 1/1/2012 12:00:00 AM | 2/12/2014 12:00:00 AM | 2/12/2014 11:01 AM |
| Contacts | Authorizing Official | Insert | | | Williford, Ellis
Interim Health Director
2522373141-6276 | 9/3/2013 11:15 AM |
| Details | Comments Public | Insert | | | 09/03/2013 AO and/or PC updated, this per the arrangement between OPA and the N.C. Department of Health and Human Services | 9/3/2013 11:15 AM |
| Contacts | Primary Contact | Insert | | | HANCOCK, KRISTEN
PHA NC STD DRUG PROGRAM
9197332030-204 | 4/16/2013 2:32 PM |
| Details | Last Recertification Date | Update | | 1/1/2011 12:00:00 AM | 1/1/2012 12:00:00 AM | 12/7/2011 11:13 AM |
| Details | Last Recertification Date | Insert | | | 1/1/2011 12:00:00 AM | 11/8/2010 3:04 PM |
| Details | Grant Number | Insert | | | STD-NC | 11/8/2010 3:04 PM |
| Details | 340B ID | Insert | | | STD27893 | 11/8/2010 3:04 PM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 11/8/2010 3:04 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 11/8/2010 3:04 PM |
| Details | Medicare Provider Number | Insert | | | | 11/8/2010 3:04 PM |
| Details | Entity Name | Insert | | | WILSON COUNTY HEALTH DEPARTMENT | 11/8/2010 3:04 PM |
| Details | Program Code | Insert | | | STD | 11/8/2010 3:04 PM |
| Details | Entity Subname | Insert | | | | 11/8/2010 3:04 PM |
| Dates | Participating Approval Date | Insert | | | 12/4/2008 12:00:00 AM | 11/8/2010 3:04 PM |
| Details | State | Insert | | | Active | 11/8/2010 3:04 PM |
| Dates | Registration Date | Insert | | | 12/3/2008 12:00:00 AM | 11/8/2010 3:04 PM |
| Dates | Signed By Date | Insert | | | 1/1/2011 12:00:00 AM | 11/8/2010 3:04 PM |
| Dates | Start Date | Insert | | | 1/1/2009 12:00:00 AM | 11/8/2010 3:04 PM |
| Terminations | Termination Comments | Insert | | | | 11/8/2010 3:04 PM |
| Terminations | Termination Date | Insert | | | | 11/8/2010 3:04 PM |
| Terminations | Termination Effective Date | Insert | | | | 11/8/2010 3:04 PM |
| Terminations | Termination Reason | Insert | | | | 11/8/2010 3:04 PM |