Provider Demographics
NPI:1407914161
Name:COMMUNITY HEALTH FOUNDATION
Entity Type:Organization
Organization Name:COMMUNITY HEALTH FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HASTINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-583-6541
Mailing Address - Street 1:600 EAST MCDONALD AVENUE
Mailing Address - Street 2:
Mailing Address - City:MAN
Mailing Address - State:WV
Mailing Address - Zip Code:25635-1097
Mailing Address - Country:US
Mailing Address - Phone:304-583-6541
Mailing Address - Fax:304-583-6018
Practice Address - Street 1:600 EAST MCDONALD AVENUE
Practice Address - Street 2:
Practice Address - City:MAN
Practice Address - State:WV
Practice Address - Zip Code:25635-1097
Practice Address - Country:US
Practice Address - Phone:304-583-6541
Practice Address - Fax:304-583-6018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0035282000Medicaid
WV0035282000Medicaid