# SOUTH CHARLESTON PRIMARY CARE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689758476
- **Authorized official:** TERRI JO COLEMAN (OFFICE MANAGER)
- **Authorized official phone:** (304) 744-4532

## Contact information

- **Practice address:** 312 6TH AVE, SUITE 3, SOUTH CHARLESTON, WV 25303-1242
- **Practice address phone:** (304) 744-4532
- **Practice address fax:** (304) 744-3219
- **Mailing address:** 312 6TH AVE, SUITE 3, SOUTH CHARLESTON, WV 25303-1242
- **Mailing address phone:** (304) 744-4532
- **Mailing address fax:** (304) 744-3219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 10611 | WV | Yes |

## Other

- **Enumeration date:** 10/25/2006
- **Last updated:** 08/22/2020