Organization Name: | FREE CLINIC OF THE NEW RIVER VALLEY INC |
NPI Number: | 1043648611 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHELLE BRAUNS (EXECUTIVE DIRECTOR) |
Mailing Address: | 215 Roanoke St Christiansburg |
State: | VA US |
Postal Code: | 240733025 |
Phone Number: | 5403810820 |
Fax Number: | 5403823391 |
NPI Enumeration Date: | 10/17/2013 |
NPI Last Update Date: | 10/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |