Provider Demographics
NPI:1932488939
Name:BARBOURSVILLE URGENT CARE INC.
Entity Type:Organization
Organization Name:BARBOURSVILLE URGENT CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-690-0000
Mailing Address - Street 1:2 CHATEAU LN
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1626
Mailing Address - Country:US
Mailing Address - Phone:304-690-0000
Mailing Address - Fax:
Practice Address - Street 1:2 CHATEAU LN
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1626
Practice Address - Country:US
Practice Address - Phone:304-690-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1982261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care