| Healthy Habits Wellness Ctr, Inc | |
|
140 Stollings Ave Logan WV 25601-4011 | |
| (304) 752-4594 | |
| (304) 752-5629 |
| Full Name | Healthy Habits Wellness Ctr, Inc |
|---|---|
| Speciality | General Practice |
| Location | 140 Stollings Ave, Logan, West Virginia |
| Authorized Official Name and Position | Jon M Miller (PRESIDENT) |
| Authorized Official Contact | 3047524594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Habits Wellness Ctr, Inc 140 Stollings Ave Ste 3 Logan WV 25601-4035 Ph: (304) 752-4594 | Healthy Habits Wellness Ctr, Inc 140 Stollings Ave Logan WV 25601-4011 Ph: (304) 752-4594 |
| NPI Number | 1659323665 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 07/08/2010 |
| Medicare PECOS PAC ID | 3072539790 |
|---|---|
| Medicare Enrollment ID | O20051020001114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659323665 | NPI | - | NPPES |
| 3810002671 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 785374 (West Virginia) | Primary |
| Provider Name | Jon M Miller |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841245339 PECOS PAC ID: 5890711519 Enrollment ID: I20051022000309 |
| Provider Name | Amber M Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093049983 PECOS PAC ID: 7113068057 Enrollment ID: I20100114000031 |
| Provider Name | Darlene M Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164738530 PECOS PAC ID: 5294923306 Enrollment ID: I20101215001257 |
| Provider Name | Dena Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124403977 PECOS PAC ID: 3577860568 Enrollment ID: I20160317001797 |
| Provider Name | William Ray Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104395375 PECOS PAC ID: 5496097594 Enrollment ID: I20190419000199 |
Carlton L W Herald Do Pc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 77 Hospital Dr, Suite 100, Logan, WV 25601 Phone: 304-831-2061 Fax: 304-831-2063 | |
Southern West Virgina Health System-logan Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 122 Nick Savas Drive, Logan, WV 25601 Phone: 304-752-8081 Fax: 304-752-8083 | |
Legacy Family Medicine Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 214 Hanging Rock Hwy, Logan, WV 25601 Phone: 304-784-4495 Fax: 304-688-9020 | |
Main Street Family Practice, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 533 Main St, Logan, WV 25601 Phone: 304-752-3400 Fax: 304-752-8138 | |
Ovp Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 557 Main St, Logan, WV 25601 Phone: 740-752-3435 Fax: 740-753-3436 | |
Absolute Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 Bridge St, Logan, WV 25601 Phone: 304-896-5025 Fax: 304-896-5058 | |
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