Healthcare Provider Details

I. General information

NPI: 1073679254
Provider Name (Legal Business Name): WOMENS HEALTH CENTER OF WEST VIRGINIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 WASHINGTON ST W
CHARLESTON WV
25302-2036
US

IV. Provider business mailing address

510 WASHINGTON ST W
CHARLESTON WV
25302-2036
US

V. Phone/Fax

Practice location:
  • Phone: 304-344-9841
  • Fax: 304-344-1756
Mailing address:
  • Phone: 304-344-9841
  • Fax: 304-344-1756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number StateWV

VIII. Authorized Official

Name: MS. SHARON LEWIS
Title or Position: DIRECTOR
Credential:
Phone: 304-344-9841