Organization Name: | CAMDEN ON GAULEY MEDICAL CENTER INC |
NPI Number: | 1396119343 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARGARET HICKEY (C EO) |
Mailing Address: | 58 E Main St Richwood |
State: | WV US |
Postal Code: | 262611122 |
Phone Number: | 3048462608 |
Fax Number: | |
NPI Enumeration Date: | 11/13/2015 |
NPI Last Update Date: | 11/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |