Provider Demographics
NPI:1760447981
Name:MERIT MEDICAL RURAL HEALTH CLINIC-OAKWOOD, INC.
Entity Type:Organization
Organization Name:MERIT MEDICAL RURAL HEALTH CLINIC-OAKWOOD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:R
Authorized Official - Last Name:JAVED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-964-9102
Mailing Address - Street 1:PO BOX 900
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641
Mailing Address - Country:US
Mailing Address - Phone:276-964-9102
Mailing Address - Fax:276-963-2865
Practice Address - Street 1:1016 KENNEL GAP ROAD
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:VA
Practice Address - Zip Code:24631
Practice Address - Country:US
Practice Address - Phone:276-498-3135
Practice Address - Fax:276-498-7257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
493866Medicare Oscar/Certification