Organization
PENDLETON COMMUNITY CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE M 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
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001965507
MS BCBS
WV
05
—
5369008000
—
WV
Enumeration date
01/17/2006
Last updated
07/19/2016
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