Provider Demographics
NPI:1649561556
Name:WARREN VANCE COMMUNITY HEALTH CENTER INC
Entity type:Organization
Organization Name:WARREN VANCE COMMUNITY HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROWLETT
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICE MANAGER
Authorized Official - Phone:252-492-2161
Mailing Address - Street 1:176 S BECKFORD DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-2584
Mailing Address - Country:US
Mailing Address - Phone:252-492-2161
Mailing Address - Fax:252-438-2888
Practice Address - Street 1:176 S BECKFORD DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2584
Practice Address - Country:US
Practice Address - Phone:252-492-2161
Practice Address - Fax:252-438-2888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23579207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty