ACTIVATE HEALTHCARE - TEAMSTERS 175 & 505 CLINIC (NPI# 1578922878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578922878 |
| Entity Type | Organization |
| Organization Name | ACTIVATE HEALTHCARE - TEAMSTERS 175 & 505 CLINIC |
| Practice Address |
428 Division St Suite 2 South Charleston WV 25309-1469 |
| Mailing Address |
2010 N Damen Ave Suite F Chicago IL 60647-3284 |
| Practice Telephone | 3047680321 |
| Practice Fax Number | 3047680322 |
| Mailing Telephone | 7736973144 |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |
| Authorized Official Name | DEBRA GEIHSLER (PRINCIPAL) |
| Authorized Official Telephone | 7736973144 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
428 DIVISION ST SUITE 2 |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip Code | 25309-1469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578620696 | Badshah J. Wazir | Specialist | 428 Division St, South Charleston, WV 25309-1469 | 2007-01-02 |
| 1609216605 | Pediatric Gastroenterology of Charleston, Pllc | Pediatrics | 428 Division St, Suite 3a, South Charleston, WV 25309-1469 | 2013-07-05 |
| 1982909800 | Kimalisa Kay Shamblin | Spec/Tech, Cardiovascular | 428 Division St, South Charleston, WV 25309-1469 | 2011-01-25 |
| 1770706772 | South Charleston Cardiology Associates | Specialist | 428 Division St, South Charleston, WV 25309-1469 | 2007-04-10 |
| 1407079304 | South Charleston Cardiodiagnostics | Clinical Medical Laboratory | 428 Division St, 1st Floor, South Charleston, WV 25309-1469 | 2007-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376905 | Lovie Bradshaw | Technician | 4823 Tennessee St., South Charleston, WV 25309 | 2020-11-03 |
| 1306447735 | Barbara Mackenzie | Technician | 4224 Kanawha Turnpike, South Charleston, WV 25309 | 2020-11-03 |
| 1548861974 | Sarah Nichols | Technician | 4990 Colonial Park Dr. Apt. F, South Charleston, WV 25309 | 2020-11-03 |
| 1629690177 | Jennifer Mabry-goins | Technician | 4505 River Avenue, S Charleston, WV 25309 | 2020-05-07 |
| 1811537715 | Brandon C Dean | Psychologist | 4857 Macorkle Ave. Sw, South Charleston, WV 25309 | 2020-01-09 |
| 1467096057 | Linda Mullins | Technician | 60 Hayvon Lane, South Charleston, WV 25309 | 2019-11-06 |
| 1831743616 | Ann Myriah Beck | Nurse Practitioner | 4610 Maccorkle Ave Sw # 300, South Charleston, WV 25309 | 2019-07-30 |
| 1942671227 | Edward W Eskew | Family Medicine | 4605 Maccorkle Avenue, Sw, Thspp-psychiatry, South Charleston, WV 25309 | 2015-10-13 |
| 1720468218 | Link Investments LLC | Pharmacy | 5151 Macorkle Avenue, South Charleston, WV 25309 | 2015-06-01 |
| 1366840951 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 304 Southbridge Blvd., S.ccharleston, WV 25309 | 2014-12-12 |
| Find all providers in zip 25309 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154558260 | Michael Sitler, Md, Inc. | Clinic/Center | 855 Creekstone Rdg, South Charleston, WV 25309-9469 | 2009-06-16 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
Please comment or provide details below to improve the information on ACTIVATE HEALTHCARE - TEAMSTERS 175 & 505 CLINIC.
| 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.