Organization
CHANGE, INCORPORATED
Active
Organization
CHANGE, INCORPORATED
Active
Other names
FAMILY MEDICAL CARE Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY LYNN RAVEAUX (CHIEF EXECUTIVE OFFICER)
(304) 797-7733
Entity
Organization
Contact information
Practice address
3136 WEST ST, WEIRTON, WV 26062-4635
(304) 797-7733
Mailing address
3136 WEST ST, WEIRTON, WV 26062-4635
(304) 797-7733
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160961
CHANGE OH LICENSE
OH
01
—
2161000
CHANGE DBA FAMILY MEDICAL CARE CHC
OH
05
—
2733993
—
OH
01
—
361015
200 LURAY DRIVE WINTERSVILLE OH MEDICARE SITE #
OH
05
—
3810007536
—
WV
Enumeration date
07/27/2006
Last updated
10/30/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up