Whalio Doctors

NPI 1063731107

Jeannie Healthcare Incorporation

Organisation Exclusive Provider Organization Charleston, WV

Practice location

Address
1406 Madison St, Charleston, WV 25312-2417
Phone
(304) 345-2014
Mailing address
1406 Madison St 196 Wertz Ave., Charleston, WV 25312-2417

Authorised official

Name
Jeannie Laticia Stewart
Title
Ceo/President
Phone
(304) 345-2014

Registered specialties

Exclusive Provider Organization Primary
Managed Care Organizations Taxonomy 302F00000X Licence 99FMG (WV)

Registry record

NPI
1063731107
Entity type
Organization
NPI issued
28 May 2010
Record last updated
28 May 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.