ST CHARLES HEALTH COUNCIL INC; NPI #1942322003

Contact Information

ST CHARLES HEALTH COUNCIL INC

815 4A LAUREL AVENUE
COEBURN, VA 24230

Phone: 276-565-2764
Fax: 276-395-6990
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center

Indicates primary specialty

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NPI Profile & details for ST CHARLES HEALTH COUNCIL INC

NPI Number 1942322003

LBN Legal business name ST CHARLES HEALTH COUNCIL INC

Authorized official MALCOLM PERDUE - (CHIEF EXECUTIVE OFFICER)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/06/2007

Last updated 10/28/2016 - About 10 years ago

Identifiers

Medicaid

010376017

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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