Provider Demographics
NPI:1891868493
Name:NUNZIO P. PAGANO CC
Entity Type:Organization
Organization Name:NUNZIO P. PAGANO CC
Other - Org Name:GLENELG HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NUNZIO
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-872-3333
Mailing Address - Street 1:440 WATER ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651-1333
Mailing Address - Country:US
Mailing Address - Phone:304-872-3333
Mailing Address - Fax:304-872-2723
Practice Address - Street 1:440 WATER ST
Practice Address - Street 2:
Practice Address - City:SUMMERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26651-1333
Practice Address - Country:US
Practice Address - Phone:304-872-3333
Practice Address - Fax:304-872-2723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
409013775OtherRAILROAD MEDICARE
WV3810004563Medicaid
WV001710211OtherBCBS
WV001710211OtherBCBS
409013775OtherRAILROAD MEDICARE