Organization
CLAY-BATTELLE HEALTH SERVICES ASSOCIATION
Active
Other names
Clay-Battelle Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA J THOMAS (CEO)
(304) 432-8211
Entity
Organization
Contact information
Practice address
5861 MASON DIXON HWY, BLACKSVILLE, WV 26521
(304) 432-8211
(304) 432-8213
Mailing address
PO BOX 72, BLACKSVILLE, WV 26521-0072
(304) 432-8211
(304) 432-8213
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001709531
MS BCBS
WV
05
—
0035288000
—
WV
01
—
CN0274
RR MC
WV
01
—
CN0274
RAILROAD MEDICARE
—
Enumeration date
12/27/2006
Last updated
08/25/2021
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