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Organization

MONROE COUNTY HEALTH CENTER, BOARD OF TRUSTEES

Active
Parent organization
MONROE COUNTY HEALTH CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
MONROE COUNTY HEALTH CENTER
Authorized official
MR. JAMES M NELSON (CEO)
(304) 772-3064
Entity
Organization

Contact information

Practice address
2869 SENECA TRAIL, PETERSTOWN, WV 24963
(304) 753-4336
(304) 753-4097
Mailing address
200 HEALTH CENTER DRIVE, PO BOX 590, UNION, WV 24983
(304) 772-3064
(304) 772-3296

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001706775
BC/BS
WV
05
3810011420
WV
01
5611053
AETNA
WV
01
DB2513
MEDICARE RR GROUP
WV
Enumeration date
06/01/2007
Last updated
11/23/2015
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