Provider Demographics
NPI:1003879248
Name:COMMUNITY ACTION COMMITTEE OF PIKE CO., INC.
Entity Type:Organization
Organization Name:COMMUNITY ACTION COMMITTEE OF PIKE CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-289-2371
Mailing Address - Street 1:941 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PIKETON
Mailing Address - State:OH
Mailing Address - Zip Code:45661-9757
Mailing Address - Country:US
Mailing Address - Phone:740-289-2371
Mailing Address - Fax:
Practice Address - Street 1:941 MARKET ST
Practice Address - Street 2:
Practice Address - City:PIKETON
Practice Address - State:OH
Practice Address - Zip Code:45661-9757
Practice Address - Country:US
Practice Address - Phone:740-289-2371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0899327Medicaid
1003908930OtherWEST PORTSMOUTH FAMILY HEALTH CENTER NPI #
OH0865612Medicaid
1093044331OtherPORTSMOUTH FAMILY HEALTH CENTER NPI #
OH0873783Medicaid
OH0899336Medicaid
OH0989935Medicaid
1891887790OtherWAVERLY FAMILY HEALTH CENTER NPI #
1912099839OtherPIKETON FAMILY HEALTH CENTER NPI #
OH0829465Medicaid
OH2081349Medicaid
1023100955OtherJACKSON FAMILY HEALTH CENTER NPI
OH0100134Medicaid
1023100955OtherJACKSON FAMILY HEALTH CENTER NPI
OH2081349Medicaid
OH0899336Medicaid
OH0873783Medicaid
OHCO3618821Medicare ID - Type UnspecifiedFQHC