Organization Name: | NEW RIVER HEALTH ASSOCIATION INC |
NPI Number: | 1366749509 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN R. SCHULTZ (EXECUTIVE DIRECTOR) |
Mailing Address: | 850 Independence Road Coal City |
State: | WV US |
Postal Code: | 258231595 |
Phone Number: | 3046836905 |
Fax Number: | 3046836906 |
NPI Enumeration Date: | 02/24/2011 |
NPI Last Update Date: | 04/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | 1036-9138 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |