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General NPI Number Information
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NPI Number | 1598147431
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Entity Type | Organization
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Legal Business Name | SOUTHERN WEST VIRGINIA PRIMARY CARE INC
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Dates
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Enumeration Date | 06/28/2015
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 415 CARRIAGE DRIVE
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City | BECKLEY
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State | WV
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Zip | 25801
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Country | US
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Telephone | 304-250-0142
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Fax | 304-253-7262
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Provider Business Mailing Address
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Address Line | 415 CARRIAGE DRIVE
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City | BECKLEY
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State | WV
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Zip | 25801
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Country | US
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Telephone | 304-250-0142
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Fax | 304-253-7262
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH WAYNE MORRELLO
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Credential | DO
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Telephone | 304-250-0142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 23171147
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License Number State | WV
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