Organization
P AND P HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA A MARONEY R.T. (OWNER/OPERATOR)
(304) 845-7528
Entity
Organization
Contact information
Practice address
1612 WHEELING AVE, GLEN DALE, WV 26038-1734
(304) 280-4501
Mailing address
26 SUN VLY, GLEN DALE, WV 26038-1222
(304) 845-7528
(304) 845-5214
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
4801
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001710535
MOUNTAIN STATE BLUE CROSS
WV
05
—
0036366000
—
WV
05
—
0717013
—
OH
01
—
630001659
RAILROAD MEDICARE
WV
01
—
FAC250G
HEALTH PLAN (HMO)
—
Enumeration date
10/24/2008
Last updated
03/05/2012
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