EBENEZER MEDICAL OUTREACH INC NPI 1558796326

NPI Information

EBENEZER MEDICAL OUTREACH INC is a clinic pharmacy pharmacy in Huntington, WV. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. EBENEZER MEDICAL OUTREACH INC NPI is 1558796326. The provider is registered as an organization entity type.
The provider Is Doing Business As Ebenezer Medical Outreach, Inc.

The provider's business location address is:

1448 10TH AVE
HUNTINGTON, WV
ZIP 25701-581
Phone: (304) 529-0753
Fax: (304) 529-0591

The provider's authorized official is Gina Finley .
The authorized official title is Pic and has the following contact phone number (304) 529-0753.

The CLIA number assigned to this NPI record is 51D0862290 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/11/2013 and was last updated on 11/6/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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