Provider Demographics
NPI:1568464386
Name:GREENE COUNTY HEALTH CARE INC
Entity Type:Organization
Organization Name:GREENE COUNTY HEALTH CARE INC
Other - Org Name:GREENE DENTAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-747-8162
Mailing Address - Street 1:7 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28580-1332
Mailing Address - Country:US
Mailing Address - Phone:252-747-8162
Mailing Address - Fax:
Practice Address - Street 1:6 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:NC
Practice Address - Zip Code:28580-1333
Practice Address - Country:US
Practice Address - Phone:252-747-3846
Practice Address - Fax:252-747-2466
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREENE COUNTY HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-11
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC344554DMedicaid
NC341868Medicare ID - Type UnspecifiedUGS MEDICARE