Provider Demographics
NPI:1578556577
Name:SAXE MEDICAL SERVICES, INC
Entity Type:Organization
Organization Name:SAXE MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-736-4744
Mailing Address - Street 1:1 CHATEAU LN
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1627
Mailing Address - Country:US
Mailing Address - Phone:304-736-4700
Mailing Address - Fax:304-736-4029
Practice Address - Street 1:1 CHATEAU LN
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1627
Practice Address - Country:US
Practice Address - Phone:304-736-4700
Practice Address - Fax:304-736-4029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0008723000Medicaid
WV0008723001Medicaid
OH0117420Medicaid
OH0117420Medicaid