Organization
E. A. HAWSE HEALTH CENTER, INC.
Active
Other names
Grant Pediatrics and Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA THOMPSON (CEO)
(304) 897-5915
Entity
Organization
Contact information
Practice address
111 S GROVE ST STE 1, PETERSBURG, WV 26847-1770
(304) 257-2451
Mailing address
PO BOX 97, BAKER, WV 26801-0097
(304) 897-5915
(304) 897-6216
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
124Q00000X
Dental Hygienist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/24/2009
Last updated
01/16/2024
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