Provider Demographics
NPI:1003453317
Name:BLUESTONE HEALTH ASSOCIATION, INC.
Entity Type:Organization
Organization Name:BLUESTONE HEALTH ASSOCIATION, INC.
Other - Org Name:BLUESTONE PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-431-3410
Mailing Address - Street 1:3997 BECKLEY RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-7660
Mailing Address - Country:US
Mailing Address - Phone:304-431-5499
Mailing Address - Fax:304-431-3400
Practice Address - Street 1:106 THORN ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-3560
Practice Address - Country:US
Practice Address - Phone:681-282-5609
Practice Address - Fax:304-936-6157
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLUESTONE HEALTH ASSOCIATION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-05
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)