St Charles Health Council INC

NPI #1942322003 in Coeburn, Virginia

Provider Information

NPI Number: 1942322003
Entity Type: Organization
Organization Name: St Charles Health Council INC
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: Apr 6, 2007
Last Updated: Oct 28, 2016

Practice Location

Address: 815 4A LAUREL AVENUE
City: Coeburn
State: Virginia
ZIP Code: 24230
Phone: (276) 565-2764

Authorized Official

Name: MALCOLM PERDUE
Title: CHIEF EXECUTIVE OFFICER
Phone: (276) 546-5310

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X	Primary

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