NPIMap

Organization Active NPI

Community Health Foundation Logan

  • Military Clinical Medical Laboratory
  • Logan, WV
National Provider Identifier
1699840405
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Clinical Medical LaboratoryTaxonomy code 291900000X
Legal business name
COMMUNITY HEALTH FOUNDATION LOGAN
Practice address
HC 68 Box 1000
Suite 3
Logan, WV 25601-9620
Phone
(304) 239-3888
Fax
(304) 239-3811
NPI assigned
Nov 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Specialty (taxonomy)CodeLicenseStatePrimary
Military Clinical Medical Laboratory 291900000X WV Primary

Addresses

Primary practice location

HC 68 Box 1000
Suite 3
Logan, WV 25601-9620

Mailing address

HC 68 Box 1000
Suite 3
Logan, WV 25601-9620
Phone (304) 239-3888

Other identifiers 1

IdentifierTypeStateIssuer
3810005668MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Community Health Foundation7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699840405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 68 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": "HC 68 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 LOGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "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": "291900000X",
            "taxonomy_group": "",
            "desc": "Military Clinical Medical Laboratory",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005668",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

  • 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.