PENDLETON COMMUNITY CARE, INC. (NPI# 1427307222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427307222 |
| Entity Type | Organization |
| Organization Name | PENDLETON COMMUNITY CARE, INC. |
| Other Organization Name | HARMAN HEALTH CENTER |
| Practice Address |
1 Mott Street Harman WV 26270-0014 |
| Mailing Address |
Po Drawer 14 Harman WV 26270-0014 |
| Practice Telephone | 3042274134 |
| Practice Fax Number | 3042274522 |
| Mailing Telephone | 3042274134 |
| Mailing Fax Number | 3042274522 |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2016-06-14 |
| Authorized Official Name | MS. JAMIE HUDSON (CEO) |
| Authorized Official Telephone | 3043582355 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3810026188 | 05 |
| Other Name | Type Code |
|---|---|
| Harman Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477646693 | Pendleton Community Care, Inc. | Pharmacy | 203 N Main Street, Franklin, WV 26807 | 2006-10-02 |
| 1417931379 | Pendleton Community Care, Inc. | Clinic/Center | 16921 Mountaineer Drive, Riverton, WV 26814-0101 | 2005-12-05 |
| 1265634059 | Pendleton Community Care, Inc. | Clinical Medical Laboratory | 82 Pine St, Franklin, WV 26807-0100 | 2007-06-04 |
| 1346442134 | Pendleton Community Care, Inc. | Clinical Medical Laboratory | 16921 Mountaineer Drive, Riverton, WV 26814-0101 | 2007-06-04 |
| Street Address |
1 MOTT STREET |
| City | HARMAN |
| State | WV |
| Zip Code | 26270-0014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447591581 | Pendleton Community Care, Inc | Pharmacy | 1 Mott Street, Harman, WV 26270-0000 | 2013-03-14 |
| 1437401643 | Pendleton Community Care Inc | Clinical Medical Laboratory | 1 Mott Street, Harman, WV 26270-0014 | 2012-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083955322 | Lauren Elizabeth Jones | Pharmacist | 1 Mott St, Harman, WV 26270 | 2013-03-12 |
| 1972619351 | Bret Abraham Rosenblum | Family Medicine | 15 Mott Street, Harman, WV 26270 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083955322 | Lauren Elizabeth Jones | Pharmacist | 1 Mott St, Harman, WV 26270 | 2013-03-12 |
| 1972619351 | Bret Abraham Rosenblum | Family Medicine | 15 Mott Street, Harman, WV 26270 | 2006-08-21 |
| 1447591581 | Pendleton Community Care, Inc | Pharmacy | 1 Mott Street, Harman, WV 26270-0000 | 2013-03-14 |
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 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.