Healthcare Provider Details

I. General information

NPI: 1619707221
Provider Name (Legal Business Name): MARTINSVILLE HENRY COUNTY COALITION FOR HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 04/01/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22121 JEB STUART HWY
STUART VA
24171-5287
US

IV. Provider business mailing address

29 JONES ST
MARTINSVILLE VA
24112-2716
US

V. Phone/Fax

Practice location:
  • Phone: 276-638-0787
  • Fax: 276-629-2695
Mailing address:
  • Phone: 276-638-0787
  • Fax: 276-403-4353

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: GINA FINOCCHIARO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 276-403-5096