Provider Demographics
NPI:1215027826
Name:TWIN COUNTY RURAL HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:TWIN COUNTY RURAL HEALTH CENTER, INC.
Other - Org Name:RURAL HEALTH GROUP - DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE COMPLIANCE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:BELCH
Authorized Official - Last Name:BEASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CHCS
Authorized Official - Phone:252-536-5791
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-0640
Mailing Address - Country:US
Mailing Address - Phone:252-536-5880
Mailing Address - Fax:252-536-2708
Practice Address - Street 1:2064 HWY 125
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870
Practice Address - Country:US
Practice Address - Phone:252-536-5880
Practice Address - Fax:252-536-2708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC344565DMedicaid
NC03054OtherBCBS OF NORTH CAROLINA