Organization
CAMDEN ON GAULEY MEDICAL CENTER INC
Active
Organization
CAMDEN ON GAULEY MEDICAL CENTER INC
Active
Other names
Central WV Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH LYNN HAMRICK (ADMINISTRATOR)
(304) 226-5725
Entity
Organization
Contact information
Practice address
55 FRIENDS R FUN DR, SUMMERSVILLE, WV 26651-9514
(304) 872-1663
(304) 872-1804
Mailing address
PO BOX 69, CAMDEN ON GAULEY, WV 26208-0069
(304) 226-5725
(304) 226-3274
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001709708
MS BCBS
WV
05
—
0035222000
—
WV
05
—
3810014298
—
WV
01
—
5197060
AETNA
WV
01
—
CC5506
RR MEDICARE
WV
Enumeration date
01/10/2006
Last updated
11/18/2010
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