Organization
MVA X-RAY FAIRMONT CLINIC
Active
Parent organization
MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC.
Authorized official
NANCY L VANDERGRIFT MBA (PRESIDENT)
(304) 367-8740
Entity
Organization
Contact information
Practice address
1322 LOCUST AVE, FAIRMONT, WV 26554-1436
(304) 367-8740
(304) 366-9529
Mailing address
1322 LOCUST AVE, PO BOX 1112, FAIRMONT, WV 26554-1436
(304) 367-8740
(304) 366-9529
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
1034-6686
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0121537000
—
WV
Enumeration date
11/19/2010
Last updated
09/23/2011
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