Organization
COMMUNITY ACTION COMMITTEE OF PIKE CO..,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY ROBERTS (EXECUTIVE DIRECTOR)
(740) 289-2371
Entity
Organization
Contact information
Practice address
7046 STATE ROUTE 335, BEAVER, OH 45613-9034
(740) 226-1924
Mailing address
941 MARKET ST, PIKETON, OH 45661-9757
(740) 289-2371
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0100134
—
OH
05
—
0989935
—
OH
Enumeration date
03/25/2008
Last updated
04/02/2008
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