Healthcare Provider Details

I. General information

NPI: 1720858087
Provider Name (Legal Business Name): ALLCARE HEALTHCARE AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 WHITE HALL BLVD
FAIRMONT WV
26554-8219
US

IV. Provider business mailing address

235 SANDY BEACH RD
FAIRMONT WV
26554-7905
US

V. Phone/Fax

Practice location:
  • Phone: 304-476-2380
  • Fax:
Mailing address:
  • Phone: 304-368-1181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER MOLINA
Title or Position: OWNER
Credential:
Phone: 304-368-1181