Provider Demographics
NPI:1164192266
Name:MARTINSVILLE HENRY COUNTY COALITION FOR HEALTH AND WELLNESS
Entity type:Organization
Organization Name:MARTINSVILLE HENRY COUNTY COALITION FOR HEALTH AND WELLNESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FINOCCHIARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-403-5096
Mailing Address - Street 1:29 JONES ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-2716
Mailing Address - Country:US
Mailing Address - Phone:276-638-0787
Mailing Address - Fax:276-403-4353
Practice Address - Street 1:23 FAYETTE ST
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-2703
Practice Address - Country:US
Practice Address - Phone:276-638-0787
Practice Address - Fax:276-403-4397
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARTINSVILLE HENRY COUNTY COALITION FOR HEALTH AND WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-20
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)