Organization Active NPI

Ohio Valley Medical Quickcare, Inc

  • Clinical Medical Laboratory
  • Parkersburg, WV
National Provider Identifier
1205988110
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
291U00000X Issued in WV
Legal business name
OHIO VALLEY MEDICAL QUICKCARE, INC
Practice address
517 36TH St
Parkersburg, WV 26101-1006
Phone
(304) 485-1044
Fax
(304) 422-1861
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Johnny D Jurado
Title
Business Manager
Phone
(304) 485-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 291U00000X WV Primary

Addresses

Primary practice location

517 36TH St
Parkersburg, WV 26101-1006

Mailing address

417 Grand Park Dr
Suite 103
Parkersburg, WV 26105-4049
Phone (304) 485-2700

Other identifiers 4

IdentifierTypeStateIssuer
0019701003MedicaidWV
2208891MedicaidOH
0019701002MedicaidOH
2242433MedicaidWV

National Provider Directory

National Provider Directory
Tax ID family
Ohio Valley Medical Quickcare Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205988110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 GRAND PARK DR",
            "address_2": "SUITE 103",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261054049",
            "telephone_number": "304-485-2700",
            "fax_number": "304-485-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 36TH ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261011006",
            "telephone_number": "304-485-1044",
            "fax_number": "304-422-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO VALLEY MEDICAL QUICKCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JURADO",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "304-485-2700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WV",
            "license": "291U00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019701003",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2208891",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019701002",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2242433",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.