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HOLISTIC INC NPI 1811405616


NPI Information

NPI: 1811405616
Provider Name: HOLISTIC, INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 51D2143238

Address:
4815 MACCORKLE AVE SE
CHARLESTON, WV
ZIP 25304
Phone: (681) 265-1693
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HOLISTIC, INC is a family medicine in Charleston, WV. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. HOLISTIC, INC NPI is 1811405616. The provider is registered as an organization entity type.

The provider's business location address is:

4815 MACCORKLE AVE SE
CHARLESTON, WV
ZIP 25304-948
Phone: (681) 265-1693
Fax: (681) 265-0990

The provider's authorized official is Shawn Robert Blankenship .
The authorized official title is Owner and has the following contact phone number (304) 553-1576.

The CLIA number assigned to this NPI record is 51D2143238 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/15/2018 and was last updated on 8/22/2023.


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
1261QM2500XClinic/CenterMedical SpecialtyWEST VIRGINIANo
2207Q00000XFamily MedicineWEST VIRGINIAYes

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

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