Provider Demographics
NPI:1639203565
Name:ROWAN REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:ROWAN REGIONAL MEDICAL CENTER
Other - Org Name:HIVCMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR HOME HEALTH & HOSPICE
Authorized Official - Prefix:MS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:BELK
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RN
Authorized Official - Phone:704-637-7645
Mailing Address - Street 1:720 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2725
Mailing Address - Country:US
Mailing Address - Phone:704-637-7645
Mailing Address - Fax:704-637-9901
Practice Address - Street 1:720 GROVE ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2725
Practice Address - Country:US
Practice Address - Phone:704-637-7645
Practice Address - Fax:704-637-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0399251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8700319Medicaid