Organization
JEANNIE HEALTHCARE INCORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNIE LATICIA STEWART (CEO/PRESIDENT)
(304) 345-2014
Entity
Organization
Contact information
Practice address
1406 MADISON ST, CHARLESTON, WV 25312-2417
(304) 345-2014
Mailing address
1406 MADISON ST, 196 WERTZ AVE., CHARLESTON, WV 25312-2417
(304) 345-2014
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
99FMG
WV
Other
Enumeration date
05/28/2010
Last updated
05/28/2010
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