Healthcare Provider Details

I. General information

NPI: 1598955676
Provider Name (Legal Business Name): UNION CARBIDE CORPORATION A SUBSIDIARY OF THE DOW CHEMICAL COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 MACCORKLE AVE SW
SOUTH CHARLESTON WV
25303-1230
US

IV. Provider business mailing address

437 MACCORKLE AVE SW
SOUTH CHARLESTON WV
25303-1230
US

V. Phone/Fax

Practice location:
  • Phone: 304-747-2512
  • Fax: 304-747-2599
Mailing address:
  • Phone: 304-747-2512
  • Fax: 304-747-2599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CATHERINE M BAASE
Title or Position: AUTHORIZED REP OF UNION CARBIDE
Credential: MD
Phone: 989-636-6542