LIVING WATERS MEDICAL CENTER


Address: 100 Main Ave, Logan, WV 25601-3323
Phone: 3049468350

LIVING WATERS MEDICAL CENTER (NPI# 1114585619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114585619
Entity Type Organization
Organization Name LIVING WATERS MEDICAL CENTER
Practice Address 100 Main Ave
Logan
WV 25601-3323
Practice Telephone 3049468350
Enumeration Date 2019-05-31
Last Update Date 2019-05-31
Authorized Official Name MRS. AMBER ELLIS (DIRECTOR/FAMILY NURSE PRACTITIONER)
Authorized Official Telephone 3049468350
Authorized Official Credential APRN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Office Location

Street Address 100 MAIN AVE
City LOGAN
State WV
Zip Code 25601-3323

Providers in the same location

NPI Name Taxonomy Address Enumeration
1982915575 Jamie Leann Hall-jasper Podiatrist 100 Main Ave, Logan, WV 25601-3323 2010-06-29
1215334966 Logan Foot & Ankle Center Clinic/Center 100 Main Ave, Logan, WV 25601-3323 2014-11-24

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1720689805 Appalachian Medical LLC Durable Medical Equipment & Medical Supplies 218 Dingess St, Logan, WV 25601 2020-11-04
1184224909 Pamela Gail Hamlin Technician 123 Cassick Street, Logan, WV 25601 2020-10-30
1134607344 Allyson Christa Mckinney Occupational Therapy Assistant 55 Lmmh Center Road, Logan, WV 25601 2018-07-31
1841783727 Erica Lupson Nurse Practitioner 3 Mile Curve, Logan, WV 25601 2018-06-14
1861930836 Joseph Michael Mounts Counselor 312 Hudgins St, Logan, WV 25601 2017-02-09
1932647385 Melissa Campbell Occupational Therapy Assistant Wv-10, Logan, WV 25601 2017-02-06
1356891659 Brooke Bell Pharmacist Route 44 Holden Rd, Logan, WV 25601 2016-10-11
1760886469 April Workman Massage Therapist 19 A Main Avenue, Logan, WV 25601 2014-10-09
1366889081 Ashley Leann Dingess Physical Therapy Assistant 55 Logan Mingo Mental Health, Logan, WV 25601 2013-06-04
1528361466 Health Care Management, LLC Pharmacy 369 George Kostas Drive, Logan, WV 25601 2010-12-15
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639713589 Sterling Provider Group Clinic/Center 630 E 1400 N Ste 150, Logan, UT 84341-2549 2019-11-04
1447894399 Sterling Provider Group Clinic/Center 1201 S Main St Ste 110, Logan, UT 84321-8504 2019-11-04
1659724524 Norton County Hospital Clinic/Center 214 W Main St, Logan, KS 67646-9764 2016-07-15
1912368549 Sage Functional Medicine Center Clinic/Center 55 E 100 N, Suite 303, Logan, UT 84321-4661 2016-03-09
1477926806 Remack LLC Clinic/Center 2380 N 400 E, Ste C, Logan, UT 84341-6000 2015-11-06
1316329220 Jacob Douglas Anderson Clinic/Center 630 E 1400 N Ste 150, Logan, UT 84341-2549 2015-06-26
1104220409 Ohio Valley Physicians, Inc Clinic/Center 557 Main St, Logan, WV 25601-3809 2014-10-15
1952716755 Bruce A Isaacson Md PC Clinic/Center 550 E 1400 N, Suite Z, Logan, UT 84341-2406 2014-07-01
1881781144 Hopewell Health Centers Inc Clinic/Center 30381 Chieftain Drive, Logan, OH 43138-1013 2006-10-06

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1306330345 Kingwood Family Care, LLC Clinic/Center 17548 Veterans Memorial Highway, Suite D, Kingwood, WV 26537 2018-06-21
1588039242 Summersville Outpatient Center Clinic/Center 100 Florence Street, Ansted, WV 25812 2015-12-07
1801283882 Mingo County Family Wellness Center LLC Clinic/Center 50 Lenore Business Center, Williamson, WV 25661 2015-04-17
1639412398 Potomac Integrative Health Pllc Clinic/Center 51 Maddex Square Drive, Shepherdstown, WV 25443-4310 2013-04-01
1831447499 William Conrad Inc. Clinic/Center 154 Oak View Ln, New Creek, WV 26743-4544 2012-08-29
1548518095 Charles Town Health Right, Inc Clinic/Center 1212 N. Mildred St., Ranson, WV 25438-5552 2012-08-15
1154676096 Mebrahtom Tesfai Pllc Clinic/Center 212 Professional Park, Beckley, WV 25801-3624 2012-07-17
1679832646 Health Thru Care, LLC Clinic/Center 1397 Earl L. Core Road, Sabraton Plaza, Morgantown, WV 26505 2012-05-11
1811261225 Bruceton Medical Center Clinic/Center 198 Morgantown Street, Suite B, Bruceton Mills, WV 26525 2012-03-02
1629364351 Spring Valley Family Care Clinic/Center 27 Springfield Pike, Springfield, WV 26763 2011-06-21
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Competitor

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City LOGAN
Zip Code 25601

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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