Provider Demographics
NPI:1689182164
Name:MARTINSVILLE HENRY COUNTY COALITION FOR HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:MARTINSVILLE HENRY COUNTY COALITION FOR HEALTH AND WELLNESS
Other - Org Name:RIDGEWAY FAMILY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FINOCCHIARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-403-5096
Mailing Address - Street 1:4944 GREENSBORO RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWAY
Mailing Address - State:VA
Mailing Address - Zip Code:24148-3390
Mailing Address - Country:US
Mailing Address - Phone:267-956-2233
Mailing Address - Fax:276-956-1629
Practice Address - Street 1:4944 GREENSBORO RD
Practice Address - Street 2:
Practice Address - City:RIDGEWAY
Practice Address - State:VA
Practice Address - Zip Code:24148-3390
Practice Address - Country:US
Practice Address - Phone:267-956-2233
Practice Address - Fax:276-956-1629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)