ST CHARLES HEALTH COUNCIL INC (NPI# 1942322003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942322003 |
| Entity Type | Organization |
| Organization Name | ST CHARLES HEALTH COUNCIL INC |
| Other Organization Name | COEBURN FAMILY HEALTH CENTER |
| Practice Address |
815 4a Laurel Avenue Coeburn VA 24230 |
| Practice Telephone | 2765652764 |
| Practice Fax Number | 2763956990 |
| Mailing Telephone | 2765652764 |
| Mailing Fax Number | 2763956990 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2016-10-28 |
| Authorized Official Name | MALCOLM PERDUE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2765465310 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 010376017 | 05 |
| Other Name | Type Code |
|---|---|
| Coeburn Family Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215284153 | St Charles Health Council Inc | Clinic/Center | 213 Monarch Road, St Charles, VA 24282 | 2012-08-09 |
| 1053668996 | St Charles Health Council Inc | Clinic/Center | 10953 Riverside Drive, Oakwood, VA 24631 | 2012-08-09 |
| 1801060595 | St Charles Health Council Inc | Clinic/Center | 10279 Hurley Road, Hurley, VA 24620 | 2008-04-15 |
| 1710104260 | St Charles Health Council Inc | Clinic/Center | 1389 Dante Road, St Paul, VA 24283 | 2007-04-19 |
| 1992827604 | St Charles Health Council Inc | Clinic/Center | Route 80, Davenport, VA 24239 | 2007-04-04 |
| 1952423667 | St Charles Health Council Inc | Clinic/Center | 102 Oquinn Drive, Haysi, VA 24256 | 2007-04-04 |
| 1114047016 | St Charles Health Council Inc | Clinic/Center | 2534 Mendota Road, Mendota, VA 24270 | 2007-04-02 |
| 1225150824 | St Charles Health Council Inc | Clinic/Center | 20471 Azen Rd, Damascus, VA 24236-4141 | 2007-04-04 |
| 1194845552 | St Charles Health Council Inc | Clinic/Center | 536 E Main St, Appalachia, VA 24216 | 2007-03-30 |
| Street Address |
815 4A LAUREL AVENUE |
| City | COEBURN |
| State | VA |
| Zip Code | 24230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285240523 | Burley Walter Ball Jr. | Driver | 4313 Buckingham Rd, Coeburn, VA 24230 | 2020-09-22 |
| 1447736152 | Ttgi Corp | Pharmacy | 201 Laurel Ave, Coeburn, VA 24230 | 2018-07-16 |
| 1922591882 | Joshua Key | Physical Therapist | 118 Mooney Drive, Coeburn, VA 24230 | 2018-06-14 |
| 1780100024 | Jimmy F Williams Jr. | Driver | 823 Front St E, Coeburn, VA 24230 | 2017-08-18 |
| 1801175641 | Family Preservation Services, Inc. | Community/Behavioral Health | 115 Litchfield Street, Coeburn, VA 24230 | 2011-08-10 |
| 1457582041 | Family Preservation Services, Inc | Community/Behavioral Health | 518 Centre Ave Ne, Coeburn, VA 24230 | 2009-07-31 |
| 1023276854 | Sandy Ridge Volunteer Rescue Squad | Ambulance | 109 Carico Ridge, Coeburn, VA 24230 | 2008-05-29 |
| 1801089677 | Family Preservation Services | Community/Behavioral Health | 323 School House Hill Drive, Coeburn, VA 24230 | 2007-08-24 |
| 1043411184 | Community Physicians Services Corporation | Clinic/Center | 485 Front Street, Marty Shopping Center, Coeburn, VA 24230 | 2007-05-29 |
| 1578603924 | Wise Medical Group | Family Medicine | 203 Front St West, Coeburn, VA 24230 | 2007-02-07 |
| Find all providers in zip 24230 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1861909731 | The Daily Planet Inc | Clinic/Center | 2864 Hull St, Richmond, VA 23224-3680 | 2018-01-02 |
| 1427560242 | Neighborhood Health | Clinic/Center | 5000 Polk Ave, Alexandria, VA 22304-1908 | 2017-11-02 |
| 1679084297 | Neighborhood Health | Clinic/Center | 8100 Fordson Rd, Alexandria, VA 22306-3128 | 2017-10-23 |
| 1396256087 | Neighborhood Health | Clinic/Center | 1501 Cameron St, Alexandria, VA 22314-2702 | 2017-10-20 |
| 1689122186 | Monroe County Health Center Board of Trustees | Clinic/Center | 25239 Craigs Creek Rd, New Castle, VA 24127-6223 | 2016-09-14 |
| 1962950584 | Vernon J Harris East End Community Health Center | Clinic/Center | 1800 Lynhaven Ave, Richmond, VA 23224-7734 | 2016-09-12 |
| Find all providers with the same taxonomy | ||||
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| 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.