Provider Demographics
NPI:1326029109
Name:CLAY COMPREHENSIVE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:CLAY COMPREHENSIVE HEALTH SERVICES, INC.
Other - Org Name:CHATUGE FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEBBLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-389-6383
Mailing Address - Street 1:PO BOX 1309
Mailing Address - Street 2:
Mailing Address - City:HAYESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28904-1309
Mailing Address - Country:US
Mailing Address - Phone:828-389-6383
Mailing Address - Fax:828-389-2322
Practice Address - Street 1:125 MEDICAL PARK LN
Practice Address - Street 2:SUITE F
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6920
Practice Address - Country:US
Practice Address - Phone:828-837-4201
Practice Address - Fax:828-837-9359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8901332Medicaid
NC2324438Medicare ID - Type UnspecifiedGROUP MEDICARE