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General NPI Number Information
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NPI Number | 1841171121
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Entity Type | Organization
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Legal Business Name | WELLPOINT WEST VIRGINIA INC
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 200 ASSOCIATION DR STE 200
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City | CHARLESTON
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State | WV
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Zip | 25311-1278
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Country | US
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Telephone | 304-347-2483
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Fax |
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Provider Business Mailing Address
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Address Line | 200 ASSOCIATION DR STE 200
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City | CHARLESTON
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State | WV
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Zip | 25311-1278
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Country | US
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Telephone | 304-347-2483
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Fax |
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Authorized Official
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Title or Position | MANAGER, COMPLIANCE
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Name | YVETTE REDMOND
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Credential |
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Telephone | 888-716-5186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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