MANCHIN CLINIC SOUTH LLC NPI 1265605208

NPI Information

  • NPI: 1265605208
  • Provider Name: MANCHIN CLINIC SOUTH, LLC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • CLIA Number: 51D1082418
  • Address: 181 MIDDLETOWN LOOP
    WHITE HALL, WV
    ZIP 26554
  • Phone: (304) 367-9170

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NPI Details

MANCHIN CLINIC SOUTH, LLC is a clinic center in White Hall, WV. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). MANCHIN CLINIC SOUTH, LLC NPI is 1265605208. The provider is registered as an organization entity type.

The provider's business location address is:

181 MIDDLETOWN LOOP
WHITE HALL, WV
ZIP 26554-703
Phone: (304) 367-9170
Fax: (304) 367-9180

The provider's authorized official is John Manchin .
The authorized official title is Sole Member and has the following contact phone number (304) 367-9170.

The CLIA number assigned to this NPI record is 51D1082418 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/10/2008 and was last updated on 7/3/2024.

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
1261Q00000XClinic/CenterYes

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
13810011616MEDICAIDWEST 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: 3/30/2025

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