Provider Demographics
NPI:1841541877
Name:BERTIE COUNTY RURAL HEALTH ASSOCIATION
Entity type:Organization
Organization Name:BERTIE COUNTY RURAL HEALTH ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:252-794-1835
Mailing Address - Street 1:P.O. BOX 39
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:NC
Mailing Address - Zip Code:27849-0039
Mailing Address - Country:US
Mailing Address - Phone:252-348-2545
Mailing Address - Fax:252-348-2239
Practice Address - Street 1:307 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NC
Practice Address - Zip Code:27849-9694
Practice Address - Country:US
Practice Address - Phone:252-348-2545
Practice Address - Fax:252-348-2239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)