Provider Demographics
NPI:1023146313
Name:ROBESON HEALTH CARE CORPORATION
Entity type:Organization
Organization Name:ROBESON HEALTH CARE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTCEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-521-2900
Mailing Address - Street 1:60 COMMERCE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372
Mailing Address - Country:US
Mailing Address - Phone:910-521-2900
Mailing Address - Fax:910-272-1654
Practice Address - Street 1:60 COMMERCE DRIVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372
Practice Address - Country:US
Practice Address - Phone:910-521-2900
Practice Address - Fax:910-272-1654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8700241Medicaid