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General NPI Number Information
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NPI Number | 1285895433
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Entity Type | Organization
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Legal Business Name | RICHWOOD FAMILY PRACTICE
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 74 AVE B
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City | RICHWOOD
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State | WV
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Zip | 26261-0000
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Country | US
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Telephone | 304-872-8434
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Fax | 304-872-8417
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Provider Business Mailing Address
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Address Line | 74 AVE B
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City | RICHWOOD
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State | WV
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Zip | 26261-0000
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Country | US
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Telephone | 304-872-8434
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Fax | 304-872-8417
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Authorized Official
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Title or Position | CEO
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Name | MS. DEBORAH A HILL
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Credential | RN
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Telephone | 304-872-2891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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