Provider Demographics
NPI:1558533836
Name:FAMILY MEDICAL KARE
Entity Type:Organization
Organization Name:FAMILY MEDICAL KARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GENEVA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-253-5793
Mailing Address - Street 1:PO BOX 787
Mailing Address - Street 2:
Mailing Address - City:CRAB ORCHARD
Mailing Address - State:WV
Mailing Address - Zip Code:25827-0787
Mailing Address - Country:US
Mailing Address - Phone:304-253-5793
Mailing Address - Fax:304-253-0166
Practice Address - Street 1:RR 3 BOX 9
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:WV
Practice Address - Zip Code:25840-9505
Practice Address - Country:US
Practice Address - Phone:304-574-2600
Practice Address - Fax:304-574-2951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810004463Medicaid