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Organization
EBENEZER MEDICAL OUTREACH INC
Active
Organization
EBENEZER MEDICAL OUTREACH INC
Active
Other names
Ebenezer Medical Outreach, INC
Organization subpart
No
Provider details
NPI number
Authorized official
GINA FINLEY (PIC)
(304) 529-0753
Entity
Organization
Contact information
Practice address
1448 10TH AVE, HUNTINGTON, WV 25701-3581
(304) 529-0753
(304) 529-0591
Mailing address
1448 10TH AVE, HUNTINGTON, WV 25701-3581
(304) 529-0753
(304) 529-0591
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
CC0559059
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142452
PK
—
Enumeration date
09/11/2013
Last updated
11/06/2013
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