ROBESON HEALTH CARE CORPORATION (NPI# 1417914722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417914722 |
| Entity Type | Organization |
| Organization Name | ROBESON HEALTH CARE CORPORATION |
| Other Organization Name | SOUTH ROBESON MEDICAL CENTER |
| Practice Address |
1212 S Walnut St Fairmont NC 28340 |
| Mailing Address |
60 Commerce Plz Pembroke NC 28372-7386 |
| Practice Telephone | 9106286711 |
| Practice Fax Number | 9106285735 |
| Mailing Telephone | 9105212900 |
| Mailing Fax Number | 9107759165 |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2018-08-16 |
| Authorized Official Name | GEORGE TIMOTHY HALL (PRESIDENT/CEO) |
| Authorized Official Telephone | 9105212900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
MHL-078-063 | NC | Behavioral Health & Social Service Providers |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 344570 A/C | 05 | |
| NC | 6005792 | 05 |
| Other Name | Type Code |
|---|---|
| SOUTH ROBESON MEDICAL CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972157220 | Robeson Health Care Corporation | Clinic/Center | 1309 E 5th St Ste A, Lumberton, NC 28358-6031 | 2019-07-25 |
| 1083053359 | Robeson Health Care Corporation | Pharmacy | 1309 E 5th St, Lumberton, NC 28358-6031 | 2013-06-20 |
| 1750648077 | Robeson Health Care Corporation | Clinic/Center | 507 Lauchwood Dr, Laurinburg, NC 28352-5502 | 2012-04-12 |
| 1023146313 | Robeson Health Care Corporation | Case Management | 60 Commerce Drive, Pembroke, NC 28372 | 2007-03-01 |
| 1023150968 | Robeson Health Care Corporation | Counselor | 109 Cambridge Pl, Smithfield, NC 27577-4717 | 2007-02-13 |
| 1689716607 | Robeson Health Care Corporation | Counselor | 285 Camp Easter Rd, Lakeview, NC 28350-1901 | 2007-02-13 |
| 1669514683 | Robeson Health Care Corporation | Counselor | 3750 Meadow View Rd, Apt. A-1, Lumberton, NC 28358-1920 | 2007-02-13 |
| 1063554004 | Robeson Health Care Corporation | Counselor | 309 East Wardell Drive, Suite A, Pembroke, NC 28372-7998 | 2007-02-13 |
| 1063554095 | Robeson Health Care Corporation | Counselor | 3362 Frontgate Dr Apt 11, Greenville, NC 27834-8584 | 2007-02-13 |
| 1184681496 | Robeson Health Care Corporation | Counselor | 1309 E 5th Str, Lumberton, NC 28358-6031 | 2006-04-28 |
| Street Address |
1212 S WALNUT ST |
| City | FAIRMONT |
| State | NC |
| Zip Code | 28340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134124589 | Brenda Mercer Allen | Nurse Practitioner | 1212 S Walnut St, Fairmont, NC 28340-1848 | 2005-06-14 |
| 1215578448 | Mary Alexis Britt | Pharmacist | 1212 S Walnut St, Fairmont, NC 28340-1848 | 2019-09-29 |
| 1407219587 | Adam Gregory Myers | Physician Assistant | 1212 S Walnut St, Fairmont, NC 28340-1848 | 2016-04-05 |
| 1225447972 | Melissa Seals | Counselor | 1212 S Walnut St, Fairmont, NC 28340-1848 | 2014-08-07 |
| 1275969487 | Robeson Health Care Corporation | Pharmacy | 1212 S Walnut St, Fairmont, NC 28340 | 2013-09-19 |
| 1265659189 | Steven A Mclean | Pharmacist | 1212 S Walnut St, Fairmont, NC 28340-1848 | 2007-04-20 |
| 1528123387 | Karen R. Bissell | Internal Medicine | 1212 S Walnut St, Fairmont, NC 28340-1848 | 2006-12-22 |
| 1700953940 | Wendell L Richardson | Family Medicine | 1212 S Walnut St, Fairmont, NC 28340-1848 | 2006-11-30 |
| 1093899494 | Saqib Aziz | Internal Medicine | 1212 S Walnut St, Fairmont, NC 28340-1848 | 2006-10-24 |
| 1902898414 | Denis P Ricard | Physician Assistant | 1212 S Walnut St, Fairmont, NC 28340-1848 | 2005-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023250347 | Independent Community-based Services LLC | Home Health | 107 N Morro St., Fairmont, NC 28340 | 2009-04-01 |
| 1801960083 | Greenbrier Ltc Inc | Assisted Living Facility | 703 South Walnut St, Fairmont, NC 28340 | 2006-11-20 |
| 1033221130 | Jeffrey Lemont Hunter | Counselor | 314 S Main St, Fairmont, NC 28340 | 2006-08-31 |
| 1912924648 | Danny Cox | Durable Medical Equipment & Medical Supplies | 234 S Main St, Homecare Medical Products, Fairmont, NC 28340 | 2006-07-17 |
| 1952768426 | Latanya Breeden | Adult Companion | 609 Martin Luther King Dr, Fairmont, NC 28340-1311 | 2016-01-28 |
| 1033252440 | Stephens Outreach Center, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 608a Martin Luther King Dr, Fairmont, NC 28340-1312 | 2007-02-15 |
| 1629027842 | James Clifton Herring Jr. | Optometrist | 1516 Alexander St, Fairmont, NC 28340-1406 | 2006-05-06 |
| 1225142391 | Sean Brian Woken | Chiropractor | 208 Iona St, Fairmont, NC 28340-1616 | 2006-08-18 |
| 1225039340 | Lionel Nelson Chamberlain | Optometrist | 204 Iona St, Fairmont, NC 28340-1616 | 2005-08-10 |
| 1417446097 | Samuel D Johnson Od Pllc | Optometrist | 204 Iona St, Fairmont, NC 28340-1616 | 2018-05-09 |
| Find all providers in zip 28340 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1740768357 | Monongahela Valley Association of Health Centers, Inc. | Clinic/Center | 110 10th St, Fairmont, WV 26554-3607 | 2018-08-06 |
| 1578041182 | Monongahela Valley Association of Health Centers, Inc. | Clinic/Center | 221 Mason St, Fairmont, WV 26554-4188 | 2018-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831799667 | Bakersville Community Medical Clinic, Inc | Clinic/Center | 71 Blue Ridge Ln, Burnsville, NC 28714-7270 | 2020-10-30 |
| 1245842178 | Gaston Family Health Services, Inc. | Clinic/Center | 144 William Ellis Dr, Advance, NC 27006-7990 | 2020-08-21 |
| 1851909444 | Gaston Family Health Services, Inc. | Clinic/Center | 302 28th Ave Ne, Hickory, NC 28601-1116 | 2020-07-20 |
| 1750999496 | Gaston Family Health Services, Inc. | Clinic/Center | 180 War Eagle Dr, Mocksville, NC 27028-6151 | 2020-07-20 |
| 1518575265 | Gaston Family Health Services, Inc. | Clinic/Center | 4675 Oxford School Rd, Claremont, NC 28610-9468 | 2020-07-20 |
| 1124636873 | Gaston Family Health Services, Inc. | Clinic/Center | 451 Catawba Valley Blvd, Hickory, NC 28602-9631 | 2020-07-20 |
| 1093323099 | Gaston Family Health Services, Inc. | Clinic/Center | 5040 E Bandys Xrd, Catawba, NC 28609-8075 | 2020-07-16 |
| 1366088957 | Gaston Family Health Services, Inc. | Clinic/Center | 497 Farmington Rd, Mocksville, NC 27028-7639 | 2019-11-19 |
| 1285270868 | Gaston Family Health Services, Inc. | Clinic/Center | 160 Martin Luther King Junior Rd, Mocksville, NC 27028 | 2019-11-19 |
| 1306481957 | Gaston Family Health Services, Inc. | Clinic/Center | 3407 Plateau Rd, Newton, NC 28658-8809 | 2019-11-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.