Organization
UNITED PHYSICIANS CARE INC
Active
Other names
Elk Memorial Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN C FORESER (EXECUTIVE DIRECTOR)
(304) 624-4655
Entity
Organization
Contact information
Practice address
626 ELK ST, GASSAWAY, WV 26624-1136
(304) 364-2401
(304) 364-2441
Mailing address
686 S PIKE ST, STE A, SHINNSTON, WV 26431-1043
(304) 624-4655
(304) 624-3918
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
51D0881066
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008279001
—
WV
Enumeration date
12/01/2006
Last updated
01/08/2009
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