CABIN CREEK HEALTH CENTER, INC. (NPI# 1437199742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437199742 |
| Entity Type | Organization |
| Organization Name | CABIN CREEK HEALTH CENTER, INC. |
| Other Organization Name | CLENDENIN HEALTH CENTER |
| Practice Address |
107 Koontz Ave. Suite 200 Clendenin WV 25045 |
| Practice Telephone | 3045484900 |
| Mailing Telephone | 3045484900 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2014-06-06 |
| Authorized Official Name | CRAIG H. ROBINSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3047342040 |
| Authorized Official Credential | MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
031820 | WV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | MS BCBS | 001835095 | 01 |
| WV | 3810005141 | 05 | |
| WV | MS BCBS | 001881671 | 01 |
| WV | MS BCBS | 001710317 | 01 |
| WV | 3810006995 | 05 |
| Other Name | Type Code |
|---|---|
| Clendenin Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821377292 | Cabin Creek Health Center, Inc. | Clinic/Center | 1st & Brannon Street, East Bank, WV 25067-9752 | 2011-08-16 |
| 1780962340 | Cabin Creek Health Center, Inc. | Clinic/Center | 6100 Sissonville Dr, Charleston, WV 25312-9444 | 2011-08-01 |
| 1225257850 | Cabin Creek Health Center, Inc. | Clinical Medical Laboratory | State Rte 79, Dawes, WV 25054 | 2007-04-24 |
| 1538214077 | Cabin Creek Health Center, Inc. | Clinic/Center | 1 Warrior Way, Suite 103, Belle, WV 25015-1358 | 2007-01-24 |
| 1366495525 | Cabin Creek Health Center, Inc. | Clinic/Center | Route 79, Dawes, WV 25054-0070 | 2006-05-18 |
| 1063932929 | Cabin Creek Health Center, Inc. | Clinic/Center | 108 Lee St E, Charleston, WV 25301-1506 | 2017-06-22 |
| 1588908362 | Cabin Creek Health Center, Inc. | Clinic/Center | 4602 Maccorkle Ave Se, Charleston, WV 25304-1848 | 2012-11-19 |
| Street Address |
107 KOONTZ AVE. SUITE 200 |
| City | CLENDENIN |
| State | WV |
| Zip Code | 25045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669088753 | Tammie Ann Cummings | Technician | 1266 Kelliehillrd, Clendenin, WV 25045 | 2020-09-23 |
| 1467063289 | Barbara E Gross | Technician | 10546 Elk River Rd, Clendenin, WV 25045 | 2020-08-14 |
| 1437676392 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 8699 Elk River Rd North, Clendenin, WV 25045 | 2017-08-23 |
| 1982984324 | Jennifer Marie Snell | Pharmacist | 2 First Ave S, Clendenin, WV 25045 | 2011-08-17 |
| 1629290218 | Douglas Joseph Donovall Jr. | Pharmacist | 2 First Ave South, Clendenin, WV 25045 | 2007-05-03 |
| 1912085549 | Lawrence Henry Schoonover | Dentist | 1 French Street, Clendenin, WV 25045 | 2006-11-01 |
| 1790754638 | Mary E Grandon | Physician Assistant | 107 Koontz Ave. Ste. 200, Clendenin, WV 25045 | 2006-03-14 |
| 1043660160 | Caitlyn Elizabeth Nelson | Dentist | 107 Koontz Ave Ste 200, Clendenin, WV 25045 | 2016-06-20 |
| 1285928804 | Clendenin Health Center Pharmacy At Riverview | Clinic/Center | 107 Koontz Ave, Clendenin, WV 25045 | 2011-05-31 |
| 1750681011 | Lindsay A Matuszkiewicz | Pharmacist | 10 Main Street, Clendenin, WV 25045 | 2010-11-02 |
| Find all providers in zip 25045 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285928804 | Clendenin Health Center Pharmacy At Riverview | Clinic/Center | 107 Koontz Ave, Clendenin, WV 25045 | 2011-05-31 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.