Healthcare Provider Details

I. General information

NPI: 1285597286
Provider Name (Legal Business Name): CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4555 OGBURN AVE
WINSTON SALEM NC
27105-2726
US

IV. Provider business mailing address

202D MCGILL AVE NW
CONCORD NC
28025-4615
US

V. Phone/Fax

Practice location:
  • Phone: 336-703-4273
  • Fax: 336-661-4954
Mailing address:
  • Phone: 704-792-2242
  • Fax: 704-792-2250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY C GLENN
Title or Position: BILLING MANAGER
Credential:
Phone: 704-792-2256