MEDICARE: CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1053274050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CABARRUS ROWAN COMMUNITY HEALTH CENTERS, INC.

Provider Business Mailing Address
First Line	:	202D MCGILL AVE NW
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-4615
Country	:	US
Telephone Number	:	704-792-2242
Fax Number	:	704-792-2250

Provider Business Practice Location Address
First Line	:	5705 SHATTALON DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27105-1332
Country	:	US
Telephone Number	:	336-661-4880
Fax Number	:	336-245-4592

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	TIFFANY C GLENN
Credential	:
Telephone Number	:	704-792-2256

Provider Enumeration Date	:	12/05/2025
Last Update Date	:	12/05/2025

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