Cah Acquisition Company 1 LLC
Organization Active NPI Rural Health Clinic/Center · Plymouth, NC
NPI 1962650762 · NPPES record last updated May 11, 2020
Key facts
- NPI
- 1962650762
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- H0006 (NC)
- Legal business name
- CAH ACQUISITION COMPANY 1 LLC
- Practice address
- 1006 US Highway 64 E
Plymouth, NC 27962 - Phone
- (252) 793-7701
- Fax
- (252) 793-7736
- NPI assigned
- Sep 4, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- CAH ACQUISITION COMPANY 1 LLC
Authorized official
- Name
- Mr. Frank Titus Avignone IV
- Title
- Ceo
- Phone
- (214) 502-9624
Change of ownership 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Oct 1, 2020 | Change of Ownership |
Plymouth Primary Care Rural Health Clinic |
National Provider Directory
- Part of
- Cah Acquisition Company 1
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | H0006 | NC | Yes |
Addresses
Primary practice location
1006 US Highway 64 E
Plymouth, NC 27962
Mailing address
7920 Belt Line Rd Ste 215
Dallas, TX 75254-8155
Phone (214) 502-9624
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 343430A&C | Medicaid | NC | |
| 890233W | Other | NC | CAROLINA ACCESS |
Other names
- PLYMOUTH PRIMARY CARE RURAL HEALTH CLINIC
Other providers in Plymouth, NC
- Cah Acquisition Company # 1
- Cah Acquisition Company 1 LLC
- Cah Acquisition Company 1 LLC
- Cah Acquisition Company 1 LLC
- Cah Acquisition Company 1 LLC
- Kneesha Chenay Carmack
- Carolina Rebuilding Ministry
- Carolinas Home Care Inc
- James Patrick Carter
- Centennial Housing & Community Services Corporation
All providers in Plymouth, NC · Rural Health Clinic/Center in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.