NPIMap

Organization Active NPI

Monongahela Valley Association of Health Centers, Inc.

  • Clinic Pharmacy
  • Fairmont, WV
National Provider Identifier
1609979673
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
SP0550384 Issued in WV
Legal business name
MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC.
Practice address
1322 Locust Ave
Fairmont, WV 26554-1436
Phone
(304) 366-0700
Fax
(304) 366-9529
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Authorized official

Name
Manuel Raymond Alvarez
Title
Ceo
Phone
(304) 367-8740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X SP0550384 WV Primary

Addresses

Primary practice location

1322 Locust Ave
Fairmont, WV 26554-1436

Mailing address

1322 Locust Ave
PO Box 1112
Fairmont, WV 26554-1436
Phone (304) 366-0700

Other identifiers 1

IdentifierTypeStateIssuer
0035167007MedicaidWV

Other names 1

  • MVA Fairmont Clinic Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200224000508 WV Part B Supplier - Pharmacy 6800991977 Practice locations: Fairmont, WV

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

221 Mason St
Fairmont, WV 26554
Phone (304) 367-2123

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Monongahela Valley Association of Health Centers, IncMannington, WV, CCN 511115 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769731200000",
    "number": "1609979673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 LOCUST AVE",
            "address_2": "PO BOX 1112",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541436",
            "telephone_number": "304-366-0700",
            "fax_number": "304-366-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 LOCUST AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541436",
            "telephone_number": "304-366-0700",
            "fax_number": "304-366-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-367-8740"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WV",
            "license": "SP0550384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035167007",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MVA Fairmont Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MVA Fairmont Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairmont, WV

Sources for this page

Verify at the official NPI Registry.