# INTEGRATED HEALTH CARE PROVIDERS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Urology Renal Transplant
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245531177
- **Authorized official:** JEFF H. GOODE MBA (PRESIDENT)
- **Authorized official phone:** (304) 388-7782

## Contact information

- **Practice address:** 501 MORRIS ST, 5 WEST, CHARLESTON, WV 25301-1326
- **Practice address phone:** (304) 388-7823
- **Practice address fax:** (304) 388-7820
- **Mailing address:** 415 MORRIS ST, SUITE 304, CHARLESTON, WV 25301-1842
- **Mailing address phone:** (304) 388-7782
- **Mailing address fax:** (304) 388-7788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204F00000X | Transplant Surgery Physician | — | NULL | — |
| 204F00000X | Transplant Surgery Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/09/2010
- **Last updated:** 08/27/2013