Basic Information
Provider Information
NPI: 1437323722
EntityType: 2
ReplacementNPI:  
OrganizationName: MEDEXPRESS URGENT CARE, PLLC - WHEELING
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 719
Address2:  
City: DELLSLOW
State: WV
PostalCode: 265310719
CountryCode: US
TelephoneNumber: 3049853627
FaxNumber: 3049853630
Practice Location
Address1: 620 NATIONAL RD
Address2: SUITE 300
City: WHEELING
State: WV
PostalCode: 260036560
CountryCode: US
TelephoneNumber: 3042333624
FaxNumber: 3042333623
Other Information
ProviderEnumerationDate: 04/17/2008
LastUpdateDate: 10/20/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BUGIN
AuthorizedOfficialFirstName: TIMOTHY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VP OF PAYOR CONTRACTING
AuthorizedOfficialTelephone: 3042252500
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X  N193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansEmergency Medicine 
261QU0200X  Y Ambulatory Health Care FacilitiesClinic/CenterUrgent Care

No ID Information.


Home