Camden On Gauley Medical Center INC
Clinic/Center, Federally Qualified Health Center (FQHC) in Summersville, WV. Organization (NPI-2).
NPI number1013590744
StatusActive
Last updated in NPPESMay 8, 2024
Details
- NPI
- 1013590744
- Entity type
- Organization (NPI-2)
- Legal business name
- Camden On Gauley Medical Center INC
- Organization subpart
- No
- Enumeration date
- Apr 30, 2021
- Certification date
- May 8, 2024
- Last updated
- May 8, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | Yes |
| 261QD0000X | Clinic/Center, Dental | – | – |
Other names
- Camden Family Dentistry (Doing Business As)
Practice location
415 Main StSummersville, WV 26651-1343
Phone 304-872-1663 · Fax 304-872-8104
Mailing address
10003 Webster RdCamden On Gauley, WV 26208-7713
Phone 304-872-1663 · Fax 304-872-1663
Authorized official
Margaret Hickey
Ceo
3042265725
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