MEDEXPRESS URGENT CARE INC - WEST VIRGINIA NPI 1912133315

NPI Information

NPI: 1912133315
Provider Name: MEDEXPRESS URGENT CARE, INC - WEST VIRGINIA
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 51D1102020

Address:
4812 MACCORKLE AVENUE SW
SOUTH CHARLESTON, WV
ZIP 25309
Phone: (304) 768-3627
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MEDEXPRESS URGENT CARE, INC - WEST VIRGINIA is an urgent care clinic center in South Charleston, WV. MEDEXPRESS URGENT CARE, INC - WEST VIRGINIA NPI is 1912133315. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4812 MACCORKLE AVENUE SW
SOUTH CHARLESTON, WV
ZIP 25309-000
Phone: (304) 768-3627
Fax: (304) 768-2343

The provider's authorized official is Joy Kimball .
The authorized official title is Contract Manager and has the following contact phone number (763) 349-6740.

The CLIA number assigned to this NPI record is 51D1102020 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/1/2009 and was last updated on 4/9/2024.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207P00000X	Emergency Medicine		01612	WEST VIRGINIA	No
2	261QU0200X	Clinic/Center	Urgent Care			Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3810015294	MEDICAID	WEST VIRGINIA
2	01612	OTHER	WEST VIRGINIA	STATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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