Healthcare Provider Details

I. General information

NPI: 1740836873
Provider Name (Legal Business Name): WILLIAMSON HEALTH & WELLNESS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PARKWAY DR
WILLIAMSON WV
25661-3428
US

IV. Provider business mailing address

PO BOX 2080
WILLIAMSON WV
25661-2080
US

V. Phone/Fax

Practice location:
  • Phone: 304-236-5902
  • Fax: 855-487-4047
Mailing address:
  • Phone: 304-236-5902
  • Fax: 855-487-4047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER DONOVAN BECKETT
Title or Position: CEO
Credential:
Phone: 304-236-5902