Provider Demographics
NPI:1205204476
Name:CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.
Entity Type:Organization
Organization Name:CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.
Other - Org Name:NORTHERN ROWAN FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:M
Authorized Official - Last Name:VANDERBURG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-792-2210
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:704-792-2210
Mailing Address - Fax:704-792-2272
Practice Address - Street 1:300 N SALISBURY AVE
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:NC
Practice Address - Zip Code:28159-2514
Practice Address - Country:US
Practice Address - Phone:704-216-2630
Practice Address - Fax:704-216-2645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-04
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)