Modern Medicine Inc

LBN: Modern Medicine Inc
Modern Medicine Inc is an health care organization with primary practice located at 4114 1St Ave , Nitro WV 25143. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Suppliers / Durable Medical Equipment & Medical Supplies. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Modern Medicine Inc can be contacted via phone (304) 755-0119, or through Haikal, Elias via phone (304) 755-0119.

Contact Information

Primary practice address
4114 1St Ave Nitro WV 25143
Phone: (304) 755-0119
Fax: (304) 755-0111
Website:
Map and Directions
Authorized official contact:
Name: Haikal, Elias Doctor of Medicine (MD)
Phone: (304) 755-0119

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 1111 West Virginia
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 11111 West Virginia

Profile Details

NPI number 1942256821
LBN Legal business name Modern Medicine Inc
DBA Doing business as
Authorized official Haikal, Elias Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 25th, 2006
Last updated Apr 19th, 2012 - about 12 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 1942256821 NPPES
West Virginia Other 6604540001 DME MAC
West Virginia MEDICAID 0055458000. DME MAC

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