Organization
PENDLETON COMMUNITY CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE HUDSON (CEO)
(304) 358-7230
Entity
Organization
Contact information
Practice address
82 PINE ST, FRANKLIN, WV 26807-0100
(304) 358-2355
(304) 358-3054
Mailing address
PO BOX 100, FRANKLIN, WV 26807-0100
(304) 358-2355
(304) 358-3054
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
51D0872802
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810006212
—
WV
Enumeration date
06/04/2007
Last updated
07/19/2016
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