Healthcare Provider Details

I. General information

NPI: 1013313816
Provider Name (Legal Business Name): NEW RIVER HEALTH ASSOCIATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 04/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 SUTPHIN LN
SCARBRO WV
25917-8817
US

IV. Provider business mailing address

PO BOX 337 908 SCARBRO ROAD
SCARBRO WV
25917-0337
US

V. Phone/Fax

Practice location:
  • Phone: 304-469-3345
  • Fax: 304-469-2981
Mailing address:
  • Phone: 304-469-3345
  • Fax: 304-469-2981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number1036-9138
License Number StateWV

VIII. Authorized Official

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