Provider Demographics
NPI:1720137060
Name:ROWAN COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:ROWAN COUNTY HEALTH DEPARTMENT
Other - Org Name:DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:704-216-8871
Mailing Address - Street 1:1811 E INNES ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-6030
Mailing Address - Country:US
Mailing Address - Phone:704-216-8777
Mailing Address - Fax:704-638-3129
Practice Address - Street 1:1811 E INNES ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-6030
Practice Address - Country:US
Practice Address - Phone:704-216-8777
Practice Address - Fax:704-638-3129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QD0000X
261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Not Answered261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3404380Medicaid
NC3404498Medicaid
NC0723LOtherBLUECROSSBLUESHIELD OF NC