MOUNTAIN STATES HEALTH ALLIANCE (NPI# 1609054733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609054733 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN STATES HEALTH ALLIANCE |
| Other Organization Name | BHRHC STPAUL |
| Practice Address |
16431 Wise Street Saint Paul VA 24283-3537 |
| Mailing Address |
311 Princeton Rd Ste 1 Johnson City TN 37601-2026 |
| Practice Telephone | 2767622300 |
| Practice Fax Number | 2767620612 |
| Mailing Telephone | 2767622300 |
| Mailing Fax Number | 2767620612 |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2019-12-30 |
| Authorized Official Name | MARY LYNN KRUTAK (EVP/CFO) |
| Authorized Official Telephone | 4233023423 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
VA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| BHRHC STPAUL | Doing Business As Name - Organization |
| Riverside Community Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962998732 | Mountain States Health Alliance | Home Health | 312 Cummings St Ste A, Abingdon, VA 24210-3200 | 2018-07-05 |
| 1336635192 | Mountain States Health Alliance | Hospice, Inpatient | 312 Cummings St Ste B, Abingdon, VA 24210-3200 | 2018-07-05 |
| 1669902243 | Mountain States Health Alliance | Hospice Care, Community Based | 312 Hospital Dr Suite 1b, Clintwood, VA 24228 | 2017-06-15 |
| 1316476211 | Mountain States Health Alliance | Home Health | 312 Hospital Dr Suite 1a, Clintwood, VA 24228 | 2017-06-06 |
| 1073064333 | Mountain States Health Alliance | General Acute Care Hospital | 400 N St of Franklin Rd, Johnson City, TN 37604 | 2016-10-20 |
| 1245781954 | Mountain States Health Alliance | Family Medicine | 58 Carroll St Suite 3, Dept of Russell County Medical Center, Lebanon, VA 24266 | 2016-10-18 |
| 1316322555 | Mountain States Health Alliance | General Acute Care Hospital | 81 S Flanagan Avenue, Lebanon, VA 24266-4515 | 2015-07-29 |
| 1619357928 | Mountain States Health Alliance | General Acute Care Hospital | 111 S Flannagan Avenue, Lebanon, VA 24266-4515 | 2015-06-02 |
| 1700054095 | Mountain States Health Alliance | Psychiatry & Neurology | 58 Carroll Steet, Lebanon, VA 24266 | 2008-02-20 |
| 1144408279 | Mountain States Health Alliance | Hospice Care, Community Based | 75 S Flannagan Ave, Lebanon, VA 24266 | 2008-01-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Mountain States Health Alliance | 160 Mine Lake Ct Ste 200, Raleigh, NC 27615 |
| Virginia Business Entities | Mountain States Health Alliance | 400 N State of Franklin Rd, Johnson City, Tennessee 37604 |
| Street Address |
16431 WISE STREET |
| City | SAINT PAUL |
| State | VA |
| Zip Code | 24283-3537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346620655 | Mountain States Health Alliance | General Acute Care Hospital | 16431 Wise Street, Saint Paul, VA 24283 | 2015-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649510611 | Julie Large | Pharmacist | 16435 Wise St., St. Paul, VA 24283 | 2013-02-27 |
| 1144510264 | Misty D Sword Ward | Pharmacist | 16435 Wise Street, St Paul, VA 24283 | 2011-04-11 |
| 1629379292 | Family Preservation Services, Inc. | Community/Behavioral Health | 3200 Deacon Drive, Saint Paul, VA 24283 | 2010-11-12 |
| 1477736684 | Candice M Bolling | Physician Assistant | 16431 Wise St, St Paul, VA 24283 | 2007-12-11 |
| 1710104260 | St Charles Health Council Inc | Clinic/Center | 1389 Dante Road, St Paul, VA 24283 | 2007-04-19 |
| 1780712513 | James A Gross | Pharmacist | 3103 Fletcher Dr, Saint Paul, VA 24283 | 2007-03-01 |
| 1891847489 | Crystal E Burke | Social Worker | Hwy 63 North, Clinic Street, St. Paul, VA 24283 | 2007-01-17 |
| 1497839716 | Beacon of Life Ambulance Service | Ambulance | 16559 Riverside Dr, St. Paul, VA 24283 | 2006-10-24 |
| 1477571743 | Taylor D Holliday | Family Medicine | 16431 Wise St., Saint Paul, VA 24283 | 2006-07-17 |
| 1215960323 | Hamilton Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 16610 Russell Street, St Paul, VA 24283 | 2006-07-09 |
| Find all providers in zip 24283 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255965083 | True Healthcare Partner LLC | Clinic/Center | 104 North Webster Street, Saint Paul, IN 47272-9435 | 2020-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134735905 | Bay Medical & Wellness, LLC | Clinic/Center | 13794 Tidewater Trl, Saluda, VA 23149-2314 | 2020-09-17 |
| 1154948271 | Carilion Giles Community Hospital | Clinic/Center | 22890 Virgil Goode Hwy., Boones Mill, VA 24065 | 2020-07-06 |
| 1760008387 | Carilion Healthcare Corporation | Clinic/Center | 22890 Virgil H Goode Highway, Boones Mill, VA 24065 | 2020-06-19 |
| 1457840183 | Warren Memorial Hospital, Inc. | Clinic/Center | 315 W 10th St Ste 1, Front Royal, VA 22630-2812 | 2018-05-08 |
| 1154857019 | Bath County Community Hospital | Clinic/Center | 713 S Monroe Ave, Covington, VA 24426-1832 | 2017-05-11 |
| 1891154019 | Appalachian Regional Healthcare, Inc. | Clinic/Center | 121 Stacy Dr, Pennington Gap, VA 24277-1929 | 2016-02-16 |
| 1366791972 | Free Clinic of Franklin County | Clinic/Center | 1171 Franklin Street, Rocky Mount, VA 24151 | 2012-08-29 |
| 1487818902 | St. Mary's Health Wagon | Clinic/Center | 233 Chase St., Clintwood, VA 24228 | 2008-07-14 |
| 1013199322 | Page Memorial Hospital, Inc. | Clinic/Center | 505 Williams Ave, Shenandoah, VA 22849-1263 | 2007-11-28 |
| 1164623211 | Trillium Medical Group of Virginia | Clinic/Center | Hwy 58, Dryden, VA 24243 | 2007-05-29 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAUL |
| Zip Code | 24283 |
Please comment or provide details below to improve the information on MOUNTAIN STATES HEALTH ALLIANCE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.