Provider Demographics
NPI:1649277476
Name:COMMUNITY HEALTH ASSOCIATION
Entity type:Organization
Organization Name:COMMUNITY HEALTH ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-373-1475
Mailing Address - Street 1:PO BOX 720
Mailing Address - Street 2:122 PINNELL STREET
Mailing Address - City:RIPLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25271-0720
Mailing Address - Country:US
Mailing Address - Phone:304-373-1477
Mailing Address - Fax:304-372-2749
Practice Address - Street 1:122 PINNELL STREET
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-0720
Practice Address - Country:US
Practice Address - Phone:304-373-1477
Practice Address - Fax:304-372-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV52275N00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV512320OtherSWING BED
WV5100181OtherMEDICARE- ID
WV3910000963Medicaid
WV51-Z320OtherSWING BED
WV51U018OtherSWING BED
WV3810023822Medicaid
WV510018Medicare ID - Type Unspecified
WV511320Medicare Oscar/Certification