ST CHARLES HEALTH COUNCIL INC NPI 1710104260

NPI Information

NPI: 1710104260
Provider Name: ST CHARLES HEALTH COUNCIL INC

Doing Business As: WILLIAM A DAVIS CLINIC

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
1389 DANTE ROAD
ST PAUL, VA
ZIP 24283
Phone: (276) 762-0770
Get Directions

ST CHARLES HEALTH COUNCIL INC is a federally qualified health center (fqhc) clinic center in St Paul, VA. ST CHARLES HEALTH COUNCIL INC NPI is 1710104260. The provider is registered as an organization entity type.
The provider Is Doing Business As William A Davis Clinic.

The provider's business location address is:

1389 DANTE ROAD
ST PAUL, VA
ZIP 24283
Phone: (276) 762-0770
Fax: (276) 762-0678

The provider's authorized official is Malcolm Perdue .
The authorized official title is Ceo and has the following contact phone number (276) 546-5310.

The enumeration date for this NPI number is 4/19/2007 and was last updated on 7/29/2010.

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
1	261QF0400X	Clinic/Center	Federally 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
1	C03823	MEDICARE PIN	VIRGINIA
2	007602979	MEDICAID	VIRGINIA
3	491815	MEDICARE OSCAR/CERTIFICATION	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: 4/28/2024

NPI Synchronization or Removal

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