Provider Demographics
NPI:1891798054
Name:GREENE COUNTY HEALTH CARE INCORPORATED
Entity Type:Organization
Organization Name:GREENE COUNTY HEALTH CARE INCORPORATED
Other - Org Name:SNOW HILL INTEGRATED CARE SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAPHNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTS-HEMBY
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:252-747-8163
Practice Address - Street 1:1106 KINGOLD BLVD
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:NC
Practice Address - Zip Code:28580-1619
Practice Address - Country:US
Practice Address - Phone:252-747-2921
Practice Address - Fax:252-221-5879
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREENE COUNTY HEALTH CARE INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-05-23
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC64938261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC344554Medicaid
341836Medicare ID - Type UnspecifiedUGS MEDICARE