Healthcare Provider Details

I. General information

NPI: 1346266848
Provider Name (Legal Business Name): BLUESTONE HEALTH ASSOCIATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3997 BECKLEY RD
PRINCETON WV
24740-7660
US

IV. Provider business mailing address

3997 BECKLEY RD
PRINCETON WV
24740-7660
US

V. Phone/Fax

Practice location:
  • Phone: 304-431-5499
  • Fax: 304-431-3400
Mailing address:
  • Phone: 304-431-5499
  • Fax: 304-431-3400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MRS. LINDA SUE HUTCHENS
Title or Position: CEO
Credential:
Phone: 304-431-5499