Provider Demographics
NPI:1558652784
Name:WARREN-VANCE COMMUNITY HEALTH CENTER, INC.
Entity type:Organization
Organization Name:WARREN-VANCE COMMUNITY HEALTH CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:COLLINS-OGLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-572-2610
Mailing Address - Street 1:120 CHARLES ROLLINS RD.
Mailing Address - Street 2:SUITE 205
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-2882
Mailing Address - Country:US
Mailing Address - Phone:252-572-2610
Mailing Address - Fax:252-572-2621
Practice Address - Street 1:120 CHARLES ROLLINS RD.
Practice Address - Street 2:SUITE 205
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2882
Practice Address - Country:US
Practice Address - Phone:252-572-2610
Practice Address - Fax:252-572-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-21
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RI0200X
NC1077723261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty