Organization
UNITED PHYSICIANS CARE INC
Active
Other names
Bridgeport Physicians Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN C FORESTER (CHIEF EXECUTIVE OFFICER)
(304) 624-4655
Entity
Organization
Contact information
Practice address
1511 JOHNSON AVE, STE 104, BRIDGEPORT, WV 26330-1016
(304) 848-0702
(304) 848-0705
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
51D1071522
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810010590
—
WV
Enumeration date
12/31/2007
Last updated
01/08/2009
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