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General NPI Number Information
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NPI Number | 1669920161
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Entity Type | Organization
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Legal Business Name | NEW RIVER HEALTH ASSOCIATION, INC
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 2 VALLEY AVE
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City | RICHWOOD
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State | WV
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Zip | 26261-1331
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Country | US
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Telephone | 304-469-2905
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Fax | 304-469-2981
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Provider Business Mailing Address
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Address Line | PO BOX 337
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City | SCARBRO
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State | WV
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Zip | 25917-0337
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Country | US
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Telephone | 304-469-2905
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Fax | 304-465-5486
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | JOHN R. SCHULTZ
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Credential |
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Telephone | 304-469-2905
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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 | 1036-9138
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License Number State | WV
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