1811262710 NPI number — OASIS HEALTH AND WELLNESS PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811262710 NPI number — OASIS HEALTH AND WELLNESS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OASIS HEALTH AND WELLNESS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811262710
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 COMMERCE CIR
Provider Second Line Business Mailing Address:
200
Provider Business Mailing Address City Name:
KEARNEYSVILLE
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25430-4973
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-724-9401
Provider Business Mailing Address Fax Number:
304-724-9403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 COMMERCE CIR
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
KEARNEYSVILLE
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25430-4973
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-724-9401
Provider Business Practice Location Address Fax Number:
304-724-9403
Provider Enumeration Date:
03/12/2012

Additional Information

Authorized Official

Authorized Official Last Name:
WINSECK
Authorized Official First Name:
JASON
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
304-724-9401

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  943 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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