NPI | 1811081821 |
---|---|
Doing Business As | RUPERT HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | DEBRA J BENNETT Credentialing Specialist 304-438-6188 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: WV 054272) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2024-06-06 |