Provider Demographics
NPI:1467512152
Name:HYGEIA FACILITIES FOUNDATION INC
Entity Type:Organization
Organization Name:HYGEIA FACILITIES FOUNDATION INC
Other - Org Name:RALEIGH BOONE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRAR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-854-1323
Mailing Address - Street 1:37456 COAL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WHITESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25209-9077
Mailing Address - Country:US
Mailing Address - Phone:304-845-1323
Mailing Address - Fax:304-854-1031
Practice Address - Street 1:37456 COAL RIVER RD
Practice Address - Street 2:
Practice Address - City:WHITESVILLE
Practice Address - State:WV
Practice Address - Zip Code:25209-9077
Practice Address - Country:US
Practice Address - Phone:304-845-1323
Practice Address - Fax:304-854-1031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0011696001Medicaid
WV9906911Medicare PIN
WV511822Medicare Oscar/Certification