PAIN MANAGEMENT 360 LLC NPI 1821717711

NPI Information

  • NPI: 1821717711
  • Provider Name: PAIN MANAGEMENT 360 LLC
  • Classification: Pain Medicine - 208VP0014X
  • Specialization: Interventional Pain Medicine
  • Entity Type: Organization
  • Address: 551 21ST ST
    HUNTINGTON, WV
    ZIP 25703
  • Phone: (917) 935-7788

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NPI Details

PAIN MANAGEMENT 360 LLC is an interventional pain medicine pain medicine in Huntington, WV. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. PAIN MANAGEMENT 360 LLC NPI is 1821717711. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

551 21ST ST
HUNTINGTON, WV
ZIP 25703-540
Phone: (917) 935-7788
Fax: (304) 577-8615

The provider's authorized official is Rudy Malayil .
The authorized official title is Owner and has the following contact phone number (917) 645-2591.

The enumeration date for this NPI number is 8/24/2022 and was last updated on 4/26/2024.

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
1208VP0014XPain MedicineInterventional Pain MedicineYes
2363A00000XPhysician AssistantNo
3363LF0000XNurse PractitionerFamilyNo

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
10000210MEDICAIDOHIO
27100858920MEDICAIDKENTUCKY
37100858910MEDICAIDKENTUCKY
41821717711MEDICAIDWEST 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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