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General NPI Number Information
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NPI Number | 1689122186
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Entity Type | Organization
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Legal Business Name | MONROE COUNTY HEALTH CENTER BOARD OF TRUSTEES
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 25239 CRAIGS CREEK RD
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City | NEW CASTLE
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State | VA
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Zip | 24127-6223
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Country | US
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Telephone | 540-864-6322
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 590
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City | UNION
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State | WV
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Zip | 24983-0590
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MICHELLE BALLARD
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Credential |
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Telephone | 302-772-3064
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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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