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NPI Code Detail

MEDICARE: BLUESTONE HEALTH ASSOCIATION, INC.

MEDICARE: BLUESTONE HEALTH ASSOCIATION, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1003453317
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUESTONE HEALTH ASSOCIATION, INC.
Provider Business Mailing Address
First Line : 3997 BECKLEY RD
Second Line :
City : PRINCETON
State : WV
Zip : 24740-7660
Country : US
Telephone Number : 304-431-5499
Fax Number : 304-431-3400
Provider Business Practice Location Address
First Line : 106 THORN ST
Second Line :
City : PRINCETON
State : WV
Zip : 24740-3560
Country : US
Telephone Number : 681-282-5609
Fax Number : 304-936-6157
Authorized Official
Title or Position : CEO
Name : LINDA HUTCHENS
Credential :
Telephone Number : 304-431-3410
Provider Enumeration Date : 12/05/2019
Last Update Date : 02/24/2021

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