Organization
PRESTON HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GOODWIN JR. (OWNER)
(304) 441-2001
Entity
Organization
Contact information
Practice address
1343 N PRESTON HWY, KINGWOOD, WV 26537-7633
(304) 441-2001
(304) 441-2009
Mailing address
1343 N PRESTON HWY, KINGWOOD, WV 26537-7633
(304) 441-2001
(304) 441-2009
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary
2232-1458
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3810018394
WEST VIRGINIA MEDICAID FAMILY PLANNING
WV
Enumeration date
01/23/2014
Last updated
01/23/2014
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