Organization
WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC
Active
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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