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General NPI Number Information
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NPI Number | 1417402801
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Entity Type | Organization
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Legal Business Name | MEDEXPRESS URGENT CARE, PC - VIRGINIA
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Dates
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Enumeration Date | 08/16/2016
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 300 W RESERVOIR RD
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City | WOODSTOCK
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State | VA
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Zip | 22664-1004
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Country | US
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Telephone | 540-459-2035
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Fax | 540-459-2036
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Provider Business Mailing Address
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Address Line | 423 FORTRESS BLVD
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City | MORGANTOWN
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State | WV
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Zip | 26508-1351
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Country | US
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Telephone | 304-225-2500
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Fax | 305-985-6350
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Authorized Official
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Title or Position | CONTRACT MANAGER
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Name | JOY KIMBALL
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Credential |
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Telephone | 763-349-6740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine 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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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