Healthcare Provider Details

I. General information

NPI: 1366502254
Provider Name (Legal Business Name): HYGEIA FACILITIES FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 TRINITY LANE
OCEANA WV
24870-0400
US

IV. Provider business mailing address

37456 COAL RIVER RD
WHITESVILLE WV
25209-9077
US

V. Phone/Fax

Practice location:
  • Phone: 304-682-6246
  • Fax: 304-682-4543
Mailing address:
  • Phone: 304-854-1321
  • Fax: 304-854-1021

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: MARGARET L MARTIN
Title or Position: ADMINISTRATOR
Credential:
Phone: 304-854-1323