BRIDGEPORT EXPRESS CARE INC NPI 1912142001

NPI Information

NPI: 1912142001
Provider Name: BRIDGEPORT EXPRESS CARE INC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
2 CHENOWETH DR
BRIDGEPORT, WV
ZIP 26330
Phone: (304) 599-3129
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BRIDGEPORT EXPRESS CARE INC is a general practice in Bridgeport, WV. BRIDGEPORT EXPRESS CARE INC NPI is 1912142001. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2 CHENOWETH DR
BRIDGEPORT, WV
ZIP 26330-688
Phone: (304) 599-3129

The provider's authorized official is Timothy Peasak .
The authorized official title is President and has the following contact phone number (304) 599-3129.

The enumeration date for this NPI number is 12/4/2008 and was last updated on 1/26/2009.

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	208D00000X	General Practice				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	3810013952	MEDICAID	WEST VIRGINIA

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: 11/14/2023

NPI Synchronization or Removal

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