Provider Demographics
NPI:1346608114
Name:HOME TOWN DIRECT CARE
Entity Type:Organization
Organization Name:HOME TOWN DIRECT CARE
Other - Org Name:THOMAS RHYNE WHITE MD, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RHYNE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-435-1100
Mailing Address - Street 1:301 E. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CHERRYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28021
Mailing Address - Country:US
Mailing Address - Phone:704-435-1100
Mailing Address - Fax:704-802-4551
Practice Address - Street 1:301 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHERRYVILLE
Practice Address - State:NC
Practice Address - Zip Code:28021
Practice Address - Country:US
Practice Address - Phone:704-435-1100
Practice Address - Fax:704-802-4551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26410207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty