Organization
WIRT COUNTY HEALTH SERVICES ASSOCIATION INC
Active
Organization
WIRT COUNTY HEALTH SERVICES ASSOCIATION INC
Active
Other names
Ripley Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI L. KNICELY (BILLING/CREDENTIALING SUPERVISOR)
(304) 275-3301
Entity
Organization
Contact information
Practice address
512A SOUTH CHURCH STREET, RIPLEY, WV 25271-9710
(304) 372-1033
(304) 372-0223
Mailing address
PO BOX 609, ELIZABETH, WV 26143-0609
(304) 275-3301
(304) 275-4798
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009486002
—
WV
Enumeration date
08/07/2007
Last updated
01/03/2014
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