Organization
ST CHARLES HEALTH COUNCIL INC
Active
Organization
ST CHARLES HEALTH COUNCIL INC
Active
Other names
Council Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MALCOLM PERDUE (CHIEF EXECUTIVE OFFICER)
(276) 546-5310
Entity
Organization
Contact information
Practice address
ROUTE 80, DAVENPORT, VA 24239
(276) 859-0859
(276) 859-0587
Mailing address
4124 COUNCIL MOUNTAIN RD, HONAKER, VA 24260-4994
(276) 859-0859
(276) 546-9708
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007602995
—
VA
Enumeration date
04/04/2007
Last updated
07/21/2021
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