Organization
ST CHARLES HEALTH COUNCIL INC
Active
Organization
ST CHARLES HEALTH COUNCIL INC
Active
Other names
William A Davis Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MALCOLM PERDUE (CEO)
(276) 546-5310
Entity
Organization
Contact information
Practice address
1389 DANTE ROAD, ST PAUL, VA 24283
(276) 762-0770
(276) 762-0678
Mailing address
CLINIC DRIVE, HIGHWAY 63 NORTH, ST PAUL, VA 24283
(276) 762-0770
(276) 762-0678
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007602979
—
VA
Enumeration date
04/19/2007
Last updated
07/29/2010
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