Healthcare Provider Details

I. General information

NPI: 1528257789
Provider Name (Legal Business Name): MUSKINGUM VALLEY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 06/21/2022
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

859 NORTH MAIN ST.
MALTA OH
43758-9007
US

IV. Provider business mailing address

716 ADAIR AVE
ZANESVILLE OH
43701-2836
US

V. Phone/Fax

Practice location:
  • Phone: 740-962-6111
  • Fax: 740-962-2182
Mailing address:
  • Phone: 740-891-9000
  • Fax: 740-891-9001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL J ATKINSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 740-891-9000