Organization
PENDLETON COMMUNITY CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L JUDY (CEO)
(304) 358-7230
Entity
Organization
Contact information
Practice address
314 PINE STREET, FRANKLIN, WV 26807
(304) 358-2355
(304) 358-3054
Mailing address
PO BOX 100, 314 PINE STREET, FRANKLIN, WV 26807-0100
(304) 358-2355
(304) 358-3054
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5050295
OMCFH
WV
Enumeration date
12/28/2007
Last updated
12/28/2007
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