Provider Demographics
NPI:1467673491
Name:BLUEFIELD HEALTH CARE
Entity Type:Organization
Organization Name:BLUEFIELD HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ARANIBAR HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-320-5107
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:HICO
Mailing Address - State:WV
Mailing Address - Zip Code:25854-0217
Mailing Address - Country:US
Mailing Address - Phone:304-320-5107
Mailing Address - Fax:
Practice Address - Street 1:1421 STADIUM DR
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-3319
Practice Address - Country:US
Practice Address - Phone:304-320-5107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV19844207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5630086000Medicaid
WVBL9321091Medicare ID - Type UnspecifiedMEDICARE
WV5630086000Medicaid