Provider Demographics
NPI:1619707221
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:CHIEF FINANCIAL OFFICER
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 1:22121 JEB STUART HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:VA
Practice Address - Zip Code:24171-5287
Practice Address - Country:US
Practice Address - Phone:276-638-0787
Practice Address - Fax:276-629-2695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)