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General NPI Number Information
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NPI Number | 1104025741
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Entity Type | Organization
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Legal Business Name | PRIME HEALTH ASSOCIATES DBA
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 1315 ROBERT C. BYRD DRIVE
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City | CRAB ORCHARD
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State | WV
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Zip | 25827
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Country | US
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Telephone | 304-252-0966
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Fax | 304-252-4615
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Provider Business Mailing Address
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Address Line | PO BOX 1074
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City | CRAB ORCHARD
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State | WV
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Zip | 25827-1074
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Country | US
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Telephone | 304-252-0966
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Fax | 304-252-4615
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Authorized Official
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Title or Position | OWNER
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Name | DR. BELLA ZINZUWADIA
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Credential | M.D.
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Telephone | 304-255-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 51D0235448
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License Number State | WV
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