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General NPI Number Information
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NPI Number | 1407881691
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Entity Type | Organization
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Legal Business Name | ROANOKE CHOWAN COMMUNITY HEALTH CENTER INC
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 120 HEALTH CENTER DR
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City | AHOSKIE
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State | NC
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Zip | 27910-8161
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Country | US
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Telephone | 252-332-3548
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Fax | 252-332-1665
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Provider Business Mailing Address
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Address Line | PO BOX 669
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City | AHOSKIE
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State | NC
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Zip | 27910-0669
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Country | US
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Telephone | 252-209-0237
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Fax | 252-209-0197
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Authorized Official
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Title or Position | INTERIM CEO
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Name | LASHUN HUNTLEY
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Credential |
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Telephone | 336-829-3198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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