Organization
WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC
Active
Other names
Parkersburg Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKI L KNICELY (BILLING/CREDENTIALING SUPERVISOR)
(304) 275-3301
Entity
Organization
Contact information
Practice address
2610 CAMDEN AVE, PARKERSBURG, WV 26101-5652
(304) 917-3733
(304) 917-3750
Mailing address
2610 CAMDEN AVE, PARKERSBURG, WV 26101-5652
(304) 917-3733
(304) 917-3750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009486002
—
WV
Enumeration date
09/27/2012
Last updated
03/04/2016
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