Organization Name: | RAINELLE MEDICAL CENTER INC |
NPI Number: | 1437227766 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KRISTI M ATHA-RADER (CEO) |
Mailing Address: | 645 Kanawha Ave Rainelle |
State: | WV US |
Postal Code: | 259621013 |
Phone Number: | 3044386188 |
Fax Number: | 3044386819 |
NPI Enumeration Date: | 12/04/2006 |
NPI Last Update Date: | 10/14/2010 |
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: |