Healthcare Provider Details

I. General information

NPI: 1336524545
Provider Name (Legal Business Name): GLOBAL VASCULAR AND WOUND CARE INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 STANAFORD RD STE 202
BECKLEY WV
25801-3140
US

IV. Provider business mailing address

PO BOX 107
STANAFORD WV
25927-0107
US

V. Phone/Fax

Practice location:
  • Phone: 304-255-3601
  • Fax: 304-255-3604
Mailing address:
  • Phone: 304-255-3601
  • Fax: 304-255-3604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberWV1595
License Number StateWV

VIII. Authorized Official

Name: DR. HERBERT PE OYE
Title or Position: PRESIDENT
Credential: D.O
Phone: 304-255-3601