| Proactive Wv Corporation | |
|
269 Staunton Avenue Sw Suite 100 S. Charleston WV 25303 | |
| (304) 768-0321 | |
| (864) 990-3834 |
| Full Name | Proactive Wv Corporation |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 269 Staunton Avenue Sw, S. Charleston, West Virginia |
| Authorized Official Name and Position | Jody Addair (CLINICAL OPS PROJECT COORDINATOR) |
| Authorized Official Contact | 3175560017 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Wv Corporation 124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0754 | Proactive Wv Corporation 269 Staunton Avenue Sw Suite 100 S. Charleston WV 25303 Ph: (304) 768-0321 |
| NPI Number | 1275379810 |
|---|---|
| Provider Enumeration Date | 07/03/2024 |
| Last Update Date | 07/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275379810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |