Provider Demographics
NPI:1528304235
Name:CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.
Entity type:Organization
Organization Name:CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:704-792-2203
Mailing Address - Street 1:202D MCGILL AVE NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-4615
Mailing Address - Country:US
Mailing Address - Phone:704-792-2242
Mailing Address - Fax:704-792-2250
Practice Address - Street 1:307 E THOM ST
Practice Address - Street 2:
Practice Address - City:CHINA GROVE
Practice Address - State:NC
Practice Address - Zip Code:28023-2363
Practice Address - Country:US
Practice Address - Phone:704-792-2245
Practice Address - Fax:704-792-2250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207Q00000X261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)