Organization
COMMUNITY HEALTH ASSOCIATION
Active
Organization
COMMUNITY HEALTH ASSOCIATION
Active
Other names
Jackson General Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE L MCCOY (PRESIDENT/CEO)
(304) 373-1475
Entity
Organization
Contact information
Practice address
200 ACADEMY DRIVE, RIPLEY, WV 25271-9101
(304) 372-2731
(304) 372-2749
Mailing address
PO BOX 720, RIPLEY, WV 25271-0720
(304) 372-2731
(304) 373-3749
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
52
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134417976
NPI
WV
05
—
3810021320
—
WV
Enumeration date
07/14/2011
Last updated
06/20/2018
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