MEDICARE: NEW RIVER 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
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1104620384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW RIVER HEALTH ASSOCIATION, INC.

Provider Business Mailing Address
First Line	:	497 MALL RD
Second Line	:
City	:	OAK HILL
State	:	WV
Zip	:	25901-6216
Country	:	US
Telephone Number	:	304-469-2905
Fax Number	:	304-465-1518

Provider Business Practice Location Address
First Line	:	211 SUNSET DR
Second Line	:
City	:	BECKLEY
State	:	WV
Zip	:	25801-2825
Country	:	US
Telephone Number	:	304-469-2905
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING OFFICER
Name	:	MARISSA JOHNSON
Credential	:
Telephone Number	:	304-469-2905

Provider Enumeration Date	:	04/04/2025
Last Update Date	:	04/04/2025

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