Provider Demographics
NPI:1407502198
Name:PIONEER HEALTH CARE AND GOODS
Entity Type:Organization
Organization Name:PIONEER HEALTH CARE AND GOODS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTY
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-613-2797
Mailing Address - Street 1:9220 ALEXANDER RD
Mailing Address - Street 2:
Mailing Address - City:FRENCH CREEK
Mailing Address - State:WV
Mailing Address - Zip Code:26218-7358
Mailing Address - Country:US
Mailing Address - Phone:304-613-2797
Mailing Address - Fax:
Practice Address - Street 1:9220 ALEXANDER RD
Practice Address - Street 2:
Practice Address - City:FRENCH CREEK
Practice Address - State:WV
Practice Address - Zip Code:26218-7358
Practice Address - Country:US
Practice Address - Phone:304-613-2797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care