Provider Demographics
NPI:1326573346
Name:BELINGTON COMMUNITY MEDICAL SERVICES ASSOCIATION
Entity Type:Organization
Organization Name:BELINGTON COMMUNITY MEDICAL SERVICES ASSOCIATION
Other - Org Name:ABU WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-823-1333
Mailing Address - Street 1:70 N STURMER ST
Mailing Address - Street 2:
Mailing Address - City:BELINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26250-7403
Mailing Address - Country:US
Mailing Address - Phone:304-823-2800
Mailing Address - Fax:304-823-2703
Practice Address - Street 1:101 COLLEGE HILL DR
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416-4600
Practice Address - Country:US
Practice Address - Phone:304-823-2800
Practice Address - Fax:304-823-2703
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BELINGTON COMMUNITY MEDICAL SERVICES ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-27
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVPENDINGMedicaid
WVPENDINGMedicare PIN