Provider Demographics
NPI:1811983331
Name:NEW RIVER HEALTH ASSOCIATION, INC.
Entity type:Organization
Organization Name:NEW RIVER HEALTH ASSOCIATION, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-469-2905
Mailing Address - Street 1:497 MALL RD
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:WV
Mailing Address - Zip Code:25901-6216
Mailing Address - Country:US
Mailing Address - Phone:304-469-2905
Mailing Address - Fax:304-469-5486
Practice Address - Street 1:908 SCARBRO ROAD
Practice Address - Street 2:
Practice Address - City:SCARBRO
Practice Address - State:WV
Practice Address - Zip Code:25917
Practice Address - Country:US
Practice Address - Phone:304-469-2905
Practice Address - Fax:304-465-5486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1036-9138261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0035165000Medicaid
WV511820Medicare PIN
WV511963Medicare PIN
WV5119141Medicare PIN
WV511820Medicare Oscar/Certification
WV5119561Medicare PIN
WV511962Medicare PIN
WV5119151Medicare PIN
WV511915Medicare PIN
WV5119371Medicare PIN
WV5119631Medicare PIN
WV5119651Medicare PIN
WV5119661Medicare PIN
WV5118201Medicare PIN
WV511951Medicare PIN
WV5119511Medicare PIN
WV5119621Medicare PIN
WV511966Medicare PIN
WV511956Medicare PIN
WV511964Medicare PIN
WV5119691Medicare PIN
WV511914Medicare PIN
WV511937Medicare PIN
WV9160134Medicare PIN
WV511965Medicare PIN
WV5118211Medicare PIN
WV0035165000Medicaid
WV4393590001Medicare NSC
WV5119641Medicare PIN
WV511969Medicare PIN
WV5119701Medicare PIN
WV511970Medicare PIN