Bluestone Health Association, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Princeton, WV
NPI 1912377813 · NPPES record last updated Dec 15, 2016
Key facts
- NPI
- 1912377813
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- BLUESTONE HEALTH ASSOCIATION, INC.
- Practice address
- 200 12TH Street Ext
Princeton, WV 24740-2329 - Phone
- (304) 431-5499
- Fax
- (304) 431-3400
- NPI assigned
- Oct 5, 2015
- Organization subpart
- Yes
- Parent organization (as reported)
- BLUESTONE HEALTH ASSOCIATION, INC.
Authorized official
- Name
- Linda Hutchens
- Title
- Ceo
- Phone
- (304) 431-5499
Other NPIs on the same Medicare enrollment 1
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160426000491 | WV | Part B Supplier - Clinic/Group Practice | 3577505221 |
Receives reassigned benefits from 25 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bluefield, WV |
National Provider Directory
- Part of
- Bluestone Health Center Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
200 12TH Street Ext
Princeton, WV 24740-2329
Mailing address
200 12TH Street Ext
Princeton, WV 24740-2329
Phone (304) 431-5499
Other names
- Southern Bluestone Health Center
Other providers in Princeton, WV
- Bluefield Mental Health Center, PC
- Bluestone Health Association, Inc.
- Bluestone Health Association, Inc.
- Bluestone Health Association, Inc.
- Bluestone Health Association, Inc.
- Bluestone Health Center Pharmacy
- Melissa Bogle
- Patricia Bolen
- Josiah Bolyard
- Jordyn Boone
All providers in Princeton, WV · Federally Qualified Health Center (FQHC) in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.