Healthcare Provider Details

I. General information

NPI: 1801948807
Provider Name (Legal Business Name): OHIO VALLEY MEDICAL QUICKCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 PIKE ST
MARIETTA OH
45750-3323
US

IV. Provider business mailing address

417 GRAND PARK DR SUITE 103
PARKERSBURG WV
26105-4049
US

V. Phone/Fax

Practice location:
  • Phone: 740-374-4540
  • Fax: 740-374-3373
Mailing address:
  • Phone: 304-485-2700
  • Fax: 304-485-0481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number291U00000X
License Number StateOH

VIII. Authorized Official

Name: MR. JOHNNY D JURADO
Title or Position: BUSINESS MANAGER
Credential:
Phone: 304-485-2700