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General NPI Number Information
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NPI Number | 1528390366
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Entity Type | Organization
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Legal Business Name | INTEGRATED HEALTH CARE PROVIDERS, INC.
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 03/28/2011
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Provider Practice Location Address
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Address Line | 223 MAPLEWOOD AVE
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City | LEWISBURG
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State | WV
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Zip | 24901-9459
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Country | US
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Telephone | 304-645-2700
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Fax | 304-645-3188
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Provider Business Mailing Address
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Address Line | 415 MORRIS ST SUITE 304
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City | CHARLESTON
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State | WV
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Zip | 25301-1842
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Country | US
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Telephone | 304-388-7782
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Fax | 304-388-7788
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY H. GOODE
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Credential | MBA
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Telephone | 304-388-7782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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