MEDICARE: GREENE COUNTY HEALTH CARE INCORPORATED

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)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700888542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENE COUNTY HEALTH CARE INCORPORATED

Provider Business Mailing Address
First Line	:	7 PROFESSIONAL DR
Second Line	:
City	:	SNOW HILL
State	:	NC
Zip	:	28580-1332
Country	:	US
Telephone Number	:	252-747-8162
Fax Number	:	252-747-8163

Provider Business Practice Location Address
First Line	:	205 MARTIN L KING JR PKWY
Second Line	:
City	:	SNOW HILL
State	:	NC
Zip	:	28580-1320
Country	:	US
Telephone Number	:	252-747-4199
Fax Number	:	252-221-5308

Authorized Official
Title or Position	:	CFO
Name	:	DAPHNE BETTS-HEMBY
Credential	:
Telephone Number	:	252-747-8162

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	02/28/2024

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