Organization
PRINCETON COMMUNITY HOSPITAL ASSN., INC
Active
Other names
Bluefield Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE LYNN SPENCER (VP OF FINANCE)
(304) 487-7505
Entity
Organization
Contact information
Practice address
2111 COLLEGE AVE, BLUEFIELD, VA 24605-2002
(276) 322-4661
Mailing address
PO BOX 1369, PRINCETON, WV 24740-1369
(304) 487-7451
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49-8914
CMS CERTIFICATION NUMBER
—
Enumeration date
09/09/2010
Last updated
05/10/2022
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