1336780576 NPI number — CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336780576 NPI number — CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336780576
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
202D MCGILL AVE NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONCORD
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28025-4615
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-792-2242
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
330 JAKE ALEXANDER BLVD W
Provider Second Line Business Practice Location Address:
STE 102, 103
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28147-1384
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-519-2366
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/30/2019

Additional Information

Authorized Official

Authorized Official Last Name:
HOLLOMAN
Authorized Official First Name:
DON
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
704-792-2203

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com