# INTEGRATED HEALTH CARE PROVIDERS, INC.

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

## Provider details

- **NPI number:** 1932426277
- **Authorized official:** JEFFREY H. GOODE MBA (PRESIDENT)
- **Authorized official phone:** (304) 388-7782

## Contact information

- **Practice address:** 3100 MACCORKLE AVE SE, SUITE 408, CHARLESTON, WV 25304-1223
- **Practice address phone:** (304) 388-5280
- **Practice address fax:** (304) 388-5291
- **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 |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 19638 | WV | Yes |

## Other

- **Enumeration date:** 04/27/2010
- **Last updated:** 09/07/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 51D2006880 | CLIA NUMBER | — |