Medbrook Medical Associ Inc Phcy

LBN: Medbrook Medical Associates Inc
Medbrook Medical Associ Inc Phcy is an health care organization with primary practice located at 1370 Johnson Ave , Bridgeport WV 26330-1492. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Medbrook Medical Associates Inc can be contacted via phone (304) 842-4233, or through Nelson, Kelly via phone (304) 842-7186.

Contact Information

Primary practice address
1370 Johnson Ave Bridgeport WV 26330-1492
Phone: (304) 842-4233
Fax: (304) 842-2574
Website:
Map and Directions
Authorized official contact:
Name: Nelson, Kelly Doctor of Medicine (MD)
Phone: (304) 842-7186

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X SP0552291 West Virginia

Profile Details

NPI number 1649292228
LBN Legal business name Medbrook Medical Associates Inc
DBA Doing business as Medbrook Medical Associ Inc Phcy
Authorized official Nelson, Kelly Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 24th, 2006
Last updated Aug 11th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649292228 NPPES
Other 5012048 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 6003063000 NCPDP PROVIDER IDENTIFICATION NUMBER

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