Provider Demographics
NPI:1952306706
Name:ST FRANCIS WEST HEALTH CARE INC
Entity Type:Organization
Organization Name:ST FRANCIS WEST HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-345-2273
Mailing Address - Street 1:PO BOX 6549
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25362-0549
Mailing Address - Country:US
Mailing Address - Phone:304-345-2273
Mailing Address - Fax:304-345-2279
Practice Address - Street 1:121 WASHINGTON ST W
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-2343
Practice Address - Country:US
Practice Address - Phone:304-345-2273
Practice Address - Fax:304-345-2279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV09228291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0002101002Medicaid
WV0002101002Medicaid