| St Charles Health Council Inc | |
|
815 4a Laurel Avenue Coeburn VA 24230 | |
| (276) 565-2764 | |
| (276) 395-6990 |
| Full Name | St Charles Health Council Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 815 4a Laurel Avenue, Coeburn, Virginia |
| Authorized Official Name and Position | Malcolm Perdue (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2765465310 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Charles Health Council Inc 815 4a Laurel Avenue Coeburn VA 24230 Ph: (276) 565-2764 | St Charles Health Council Inc 815 4a Laurel Avenue Coeburn VA 24230 Ph: (276) 565-2764 |
| NPI Number | 1942322003 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 10/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942322003 | NPI | - | NPPES |
| 010376017 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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