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:
Health care specialties
| Specialty | Code | License # | 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 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649292228 | NPPES |
| Other | 5012048 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 6003063000 | NCPDP PROVIDER IDENTIFICATION NUMBER |
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