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CAMDEN ON GAULEY MEDICAL CENTER INC NPI 1558340414


NPI Information

NPI: 1558340414
Provider Name: CAMDEN ON GAULEY MEDICAL CENTER INC

Doing Business As: CENTRAL WV COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
55 FRIENDS R FUN DR
SUMMERSVILLE, WV
ZIP 26651
Phone: (304) 872-1663
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CAMDEN ON GAULEY MEDICAL CENTER INC is a federally qualified health center (fqhc) clinic center in Summersville, WV. CAMDEN ON GAULEY MEDICAL CENTER INC NPI is 1558340414. The provider is registered as an organization entity type.
The provider Is Doing Business As Central Wv Community Health Center.

The provider's business location address is:

55 FRIENDS R FUN DR
SUMMERSVILLE, WV
ZIP 26651-514
Phone: (304) 872-1663
Fax: (304) 872-1804

The provider's authorized official is Judith Lynn Hamrick .
The authorized official title is Administrator and has the following contact phone number (304) 226-5725.

The enumeration date for this NPI number is 1/10/2006 and was last updated on 11/18/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15118271MEDICARE PINWEST VIRGINIA
25197060OTHERWEST VIRGINIAAETNA
33810014298MEDICAIDWEST VIRGINIA
45118971MEDICARE PINWEST VIRGINIA
50035222000MEDICAIDWEST VIRGINIA
6D518361MEDICARE PINWEST VIRGINIA
7001709708OTHERWEST VIRGINIAMS BCBS
8511897MEDICARE OSCAR/CERTIFICATIONWEST VIRGINIA
9511941MEDICARE OSCAR/CERTIFICATIONWEST VIRGINIA
105119411MEDICARE PINWEST VIRGINIA
11CC5506OTHERWEST VIRGINIARR MEDICARE
12511827MEDICARE OSCAR/CERTIFICATIONWEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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