Provider Demographics
NPI:1689747255
Name:UNITED PHYSICIANS CARE INC
Entity Type:Organization
Organization Name:UNITED PHYSICIANS CARE INC
Other - Org Name:MAURICE C. RHODES, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:FORESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-624-4655
Mailing Address - Street 1:200 ROUTE 98 W ST
Mailing Address - Street 2:STE 401
Mailing Address - City:NUTTER FORT
Mailing Address - State:WV
Mailing Address - Zip Code:26301-4385
Mailing Address - Country:US
Mailing Address - Phone:304-622-0704
Mailing Address - Fax:304-622-0704
Practice Address - Street 1:200 ROUTE 98 W ST
Practice Address - Street 2:STE 401
Practice Address - City:NUTTER FORT
Practice Address - State:WV
Practice Address - Zip Code:26301-4385
Practice Address - Country:US
Practice Address - Phone:304-622-0704
Practice Address - Fax:304-622-6109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810007767Medicaid
WV3810007767Medicaid