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General NPI Number Information
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NPI Number | 1154439859
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Entity Type | Organization
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Legal Business Name | PRESTON TAYLOR COMMUNITY HEALTH CENTERS, INCORPORATED
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 1321 N MOUNTAINEER HIGHWAY
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City | NEWBURG
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State | WV
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Zip | 26410
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Country | US
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Telephone | 304-892-2812
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Fax | 304-892-2814
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Provider Business Mailing Address
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Address Line | 25 W BLUEMONT ST
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City | GRAFTON
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State | WV
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Zip | 26354-1242
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Country | US
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Telephone | 304-265-0312
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Fax | 304-265-0314
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ELIZABETH J GRIFFITH
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Credential |
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Telephone | 304-265-0312
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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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