Provider Demographics
NPI:1770446783
Name:CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.
Entity type:Organization
Organization Name:CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MAYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ-CACERES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-792-2315
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 1:1647 NE ASHLEY SCHOOL CIR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-5444
Practice Address - Country:US
Practice Address - Phone:336-703-4205
Practice Address - Fax:336-245-4592
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)