Eastridge

NPI 1073756920 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1073756920
Enumeration Date 04/08/2009
Last Updated 04/08/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name PAUL PAUL
Position EXECUTIVE DIRECTOR
Phone (304) 263-8954
Fax (304) 263-8141
Practice Location
235 S WATER ST
MARTINSBURG WV, 25401-4241, US
Phone (304) 263-8954
Fax (304) 263-8141
Business Location
235 S WATER ST
MARTINSBURG WV, 25401-4241, US
Phone (304) 263-8954
Fax (304) 263-8141
Toxanomy
Taxonomy Code 251S00000X
License State West Virginia
License Number BP00941825
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According to our database, Eastridge NPI is 1073756920, taxonomy code is 251S00000X and license number is BP00941825, license state is located at West Virginia. Eastridge physically located at 235 S Water St, Martinsburg WV, 25401-4241. NPI Number 1033115704 has the healthcare provider type.

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1073756920 NPI number is provided on an as is basis without warranty of any kind. 1073756920 is maintained by the National Plan & Provider Enumeration System. The contents of Eastridge are for informational purposes only.