Provider Demographics
NPI:1235801812
Name:CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.
Entity Type:Organization
Organization Name:CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.
Other - Org Name:SALISBURY HEALTH DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CEO
Authorized Official - Phone:704-792-2203
Mailing Address - Street 1:202 MCGILL AVE NW STE D
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:704-792-2256
Mailing Address - Fax:
Practice Address - Street 1:330 JAKE ALEXANDER BLVD W STE 103
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-1385
Practice Address - Country:US
Practice Address - Phone:704-519-2366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC344535AMedicaid