Provider Demographics
NPI:1235274309
Name:PUBLIC HEALTH AUTHORITY OF CABARRUS COUNTY
Entity Type:Organization
Organization Name:PUBLIC HEALTH AUTHORITY OF CABARRUS COUNTY
Other - Org Name:CABARRUS HEALTH ALLIANCE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FRED
Authorized Official - Last Name:PILKINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:D P H
Authorized Official - Phone:704-920-1000
Mailing Address - Street 1:280 CONCORD PKWY S
Mailing Address - Street 2:SUITE 110 A
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-6730
Mailing Address - Country:US
Mailing Address - Phone:704-920-1070
Mailing Address - Fax:704-920-1071
Practice Address - Street 1:280 CONCORD PKWY S
Practice Address - Street 2:SUITE 110 A
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-6730
Practice Address - Country:US
Practice Address - Phone:704-920-1070
Practice Address - Fax:704-920-1071
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PUBLIC HEALTH AUTHORITY OF CABARRUS COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-20
Last Update Date:2020-03-02
Deactivation Date:2015-03-17
Deactivation Code:
Reactivation Date:2015-04-20
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0720GOtherBCBS
NC3404425Medicaid