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General NPI Number Information
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NPI Number | 1407034887
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Entity Type | Organization
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Legal Business Name | MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTER, INC.
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 400 MAIN STREET
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City | FAIRVIEW
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State | WV
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Zip | 26570
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Country | US
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Telephone | 304-367-8710
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Fax | 304-366-9529
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Provider Business Mailing Address
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Address Line | 1322 LOCUST AVE P O BOX 1112
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City | FAIRMONT
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State | WV
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Zip | 26554-1436
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Country | US
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Telephone | 304-367-8710
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Fax | 304-366-9529
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. NANCY L VANDERGRIFT
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Credential |
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Telephone | 304-367-8740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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