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NPI Code Detail

MEDICARE: WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC

MEDICARE: WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianWV
2261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538179411
Entity Type Code : Organization
Provider Name (Legal Business Name) : WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC
Provider Business Mailing Address
First Line : PO BOX 609
Second Line :
City : ELIZABETH
State : WV
Zip : 26143-0609
Country : US
Telephone Number : 304-275-3301
Fax Number : 304-275-4798
Provider Business Practice Location Address
First Line : 483 COURT STREET
Second Line :
City : ELIZABETH
State : WV
Zip : 26143-0609
Country : US
Telephone Number : 304-275-3301
Fax Number : 304-275-4798
Authorized Official
Title or Position : BILLING/CREDENTIALING SUPERVISOR
Name : MRS. VICKI L KNICELY
Credential :
Telephone Number : 304-275-3301
Provider Enumeration Date : 08/09/2006
Last Update Date : 07/21/2022

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1902113194 — MRS. TERRI JO RANSON APRN-CNP
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Directions to “WIRT COUNTY HEALTH SERVICES ASSOCIATION, INC ” Practice Location

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