Organization
RURAL HEALTH ACCESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON BOWEN M.D. (MEDICAL DIRECTOR)
(304) 855-1200
Entity
Organization
Contact information
Practice address
386 AIRPORT RD, CHAPMANVILLE, WV 25508-9202
(304) 855-1200
(304) 855-1230
Mailing address
386 AIRPORT RD, CHAPMANVILLE, WV 25508-9202
(304) 855-1200
(304) 855-1230
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
22652
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810012177
—
WV
01
—
B02030991
MEDICARE
WV
Enumeration date
01/20/2015
Last updated
01/20/2015
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