MINGO COUNTY FAMILY WELLNESS CENTER LLC NPI 1801283882

NPI Information

NPI: 1801283882
Provider Name: MINGO COUNTY FAMILY WELLNESS CENTER LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 51D2095079

Address:
872 ROUTE 65
WILLIAMSON, WV
ZIP 25661
Phone: (304) 475-3700
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MINGO COUNTY FAMILY WELLNESS CENTER LLC is a primary care clinic center in Williamson, WV. MINGO COUNTY FAMILY WELLNESS CENTER LLC NPI is 1801283882. The provider is registered as an organization entity type.

The provider's business location address is:

872 ROUTE 65
WILLIAMSON, WV
ZIP 25661-497
Phone: (304) 475-3700
Fax: (304) 475-3780

The provider's authorized official is Aimee Michelle Colegrove .
The authorized official title is President/healthcare Provider and has the following contact phone number (304) 475-3700.

The CLIA number assigned to this NPI record is 51D2095079 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/17/2015 and was last updated on 6/30/2021.

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	261QP2300X	Clinic/Center	Primary Care			Yes

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: 5/5/2024

NPI Synchronization or Removal

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