Organization
WVU URGENT CARE LAB
Active
Other names
UNIVERSITY HEALTH ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA RUMBLE (PROVIDER ENROLLMENT)
(304) 285-7101
Entity
Organization
Contact information
Practice address
203 EAST FOURTH AVENUE SUITE B, RANSON, WV 25438
(304) 725-2273
(304) 725-9843
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 285-7100
(304) 285-7126
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
51D2047840
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011526000
WEST VIRGINIA MEDICAID
WV
Enumeration date
11/06/2012
Last updated
11/29/2012
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