Provider Demographics
NPI:1346435906
Name:MOUNTAIN VIEW SCHOOL
Entity Type:Organization
Organization Name:MOUNTAIN VIEW SCHOOL
Other - Org Name:MONROE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-772-3064
Mailing Address - Street 1:620 SCHOOL STREET
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:WV
Mailing Address - Zip Code:24983
Mailing Address - Country:US
Mailing Address - Phone:304-772-4580
Mailing Address - Fax:304-772-4581
Practice Address - Street 1:200 HEALTH CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:WV
Practice Address - Zip Code:24983
Practice Address - Country:US
Practice Address - Phone:304-772-3064
Practice Address - Fax:304-772-3296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty