LONGVIEW WELLNESS CENTER INC NPI 1093470221

NPI Information

NPI: 1093470221
Provider Name: LONGVIEW WELLNESS CENTER INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 45D1005845

Address:
1001 W FAIRMONT ST
LONGVIEW, TX
ZIP 75604
Phone: (903) 758-2610
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LONGVIEW WELLNESS CENTER INC is a federally qualified health center (fqhc) clinic center in Longview, TX. LONGVIEW WELLNESS CENTER INC NPI is 1093470221. The provider is registered as an organization entity type.

The provider's business location address is:

1001 W FAIRMONT ST
LONGVIEW, TX
ZIP 75604-511
Phone: (903) 758-2610
Fax: (903) 758-7081

The provider's authorized official is Terrie Mogavero .
The authorized official title is Credentialing Specialist and has the following contact phone number (903) 212-4763.

The CLIA number assigned to this NPI record is 45D1005845 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/2/2021 and was last updated on 1/5/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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