Provider Demographics
NPI:1649331638
Name:PUBLIC HEALTH AUTHORITY OF CABARRUS COUNTY
Entity type:Organization
Organization Name:PUBLIC HEALTH AUTHORITY OF CABARRUS COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:KOLASINSKI
Authorized Official - Last Name:SHOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-920-1345
Mailing Address - Street 1:300 MOORESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-0304
Mailing Address - Country:US
Mailing Address - Phone:704-920-1000
Mailing Address - Fax:704-934-4270
Practice Address - Street 1:300 MOORESVILLE RD
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-0304
Practice Address - Country:US
Practice Address - Phone:704-920-1000
Practice Address - Fax:704-934-4270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 261QC1500X, 261QF0050X, 261QM2500X, 261QP2300X, 261QP0905X
NC34D0865328291U00000X
NC04333336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251B00000XAgenciesCase Management
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No291U00000XLaboratoriesClinical Medical Laboratory
No3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3404313Medicaid
NC890143PMedicaid
NC8700266Medicaid
NC790223WMedicaid
NC3404313Medicaid