Provider Demographics
NPI:1912080078
Name:COMMUNITY HEALTH CARE, INC.
Entity type:Organization
Organization Name:COMMUNITY HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-272-6188
Mailing Address - Street 1:PO BOX 1633
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27402-1633
Mailing Address - Country:US
Mailing Address - Phone:336-272-6188
Mailing Address - Fax:336-272-9083
Practice Address - Street 1:512 JONATHAN LN
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-5121
Practice Address - Country:US
Practice Address - Phone:336-272-6188
Practice Address - Fax:336-272-9083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC 1880251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418118Medicaid
NC6600717Medicaid
NC6601420Medicaid