Healthcare Provider Details

I. General information

NPI: 1831246362
Provider Name (Legal Business Name): NEW RIVER HEALTH ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 JONES AVENUE
OAK HILL WV
25901-2099
US

IV. Provider business mailing address

PO BOX 337
SCARBRO WV
25917-0337
US

V. Phone/Fax

Practice location:
  • Phone: 304-469-4875
  • Fax: 304-469-8036
Mailing address:
  • Phone: 304-465-1378
  • Fax: 304-469-2981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number819778
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number1036-9138
License Number StateWV

VIII. Authorized Official

Name: MR. JOHN R. SCHULTZ
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 304-469-2905