Community Health Foundation of Logan

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

COMMUNITY HEALTH FOUNDATION OF LOGAN

Practice address

HC68 Box 1000
Suite 3
Logan, WV 25601-9620

Phone

(304) 239-3888

Fax

(304) 239-3811

NPI assigned

Apr 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert Roscoe Mays III

Title

Ceo

Phone

(304) 583-6541

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336106632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC68 BOX 1000",
            "address_2": "SUITE 3",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256019620",
            "telephone_number": "304-239-3888",
            "fax_number": "304-239-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC68 BOX 1000",
            "address_2": "SUITE 3",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256019620",
            "telephone_number": "304-239-3888",
            "fax_number": "304-239-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH FOUNDATION OF LOGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAYS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ROSCOE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-583-6541",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004108",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evie Collins
• Katelynn Collins
• Shelly Collins
• Erica Colucci, COTA
• Community Health Foundation Logan
• Ashlyn Conley
• Deangela Conley, MA CCC-SLP
• Taylor Conley
• Joshua Lee Conn
• Natasha Diamond Rio Cook

• Federally Qualified Health Center (FQHC) in Logan, WV
• Providers in Logan, WV by specialty
• Federally Qualified Health Center (FQHC) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.