Organization
COMMUNITY HEALTH ASSOCIATION
Active
Other names
Jackson General Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA GREENE (MEDICAL STAFF COORDINATOR)
(304) 373-1507
Entity
Organization
Contact information
Practice address
122 PINNELL ST, RIPLEY, WV 25271-9101
(304) 372-2731
(304) 373-1598
Mailing address
PO BOX 720, RIPLEY, WV 25271-0720
(304) 373-1519
(304) 373-1598
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3910000963
MEDICAID-ID
WV
Enumeration date
05/16/2008
Last updated
02/16/2016
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