Organization
COMMUNITY HEALTH FOUNDATION OF LOGAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT ROSCOE MAYS III (CEO)
(304) 583-6541
Entity
Organization
Contact information
Practice address
HC68 BOX 1000, SUITE 3, LOGAN, WV 25601-9620
(304) 239-3888
(304) 239-3811
Mailing address
HC68 BOX 1000, SUITE 3, LOGAN, WV 25601-9620
(304) 239-3888
(304) 239-3811
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810004108
—
WV
Enumeration date
04/28/2006
Last updated
08/22/2020
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