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General NPI Number Information
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NPI Number | 1003879248
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Entity Type | Organization
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Legal Business Name | COMMUNITY ACTION COMMITTEE OF PIKE CO., INC.
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 941 MARKET ST
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City | PIKETON
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State | OH
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Zip | 45661-9757
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Country | US
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Telephone | 740-289-2371
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Fax |
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Provider Business Mailing Address
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Address Line | 941 MARKET ST
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City | PIKETON
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State | OH
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Zip | 45661-9757
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Country | US
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Telephone | 740-289-2371
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. RAY ROBERTS
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Credential |
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Telephone | 740-289-2371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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