PENDLETON COMMUNITY CARE INC NPI 1912314667

NPI Information

NPI: 1912314667
Provider Name: PENDLETON COMMUNITY CARE INC

Other Name: BRANDYWINE ELEMENTARY SCHOOL SBHC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
11480 BLUE GRAY TRAIL
BRANDYWINE, WV
ZIP 26802
Phone: (304) 249-5381
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PENDLETON COMMUNITY CARE INC is a federally qualified health center (fqhc) clinic center in Brandywine, WV. PENDLETON COMMUNITY CARE INC NPI is 1912314667. The provider is registered as an organization entity type.
The provider Other Name Is Brandywine Elementary School Sbhc.

The provider's business location address is:

11480 BLUE GRAY TRAIL
BRANDYWINE, WV
ZIP 26802-247
Phone: (304) 249-5381

The provider's authorized official is Jamie Hudson .
The authorized official title is Ceo and has the following contact phone number (304) 358-2355.

The CLIA number assigned to this NPI record is 51D0872802 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/15/2014 and was last updated on 7/19/2016.

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	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			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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