Ubc Late Stage Inc

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

License

MO0560083 Issued in WV

Legal business name

UBC LATE STAGE INC

Doing business as

UBC Late Stage, Inc.

Practice address

200 Pinecrest PLZ
Morgantown, WV 26505-8065

Phone

(304) 291-7524

Fax

(304) 292-6391

NPI assigned

Jan 15, 2010

Organization subpart

No

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

Authorized official

Name

Amy Miller, PHARMD

Title

Director

Phone

(304) 291-7524

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• UBC Late Stage, Inc. Doing business as

Locations

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1457682460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PINECREST PLZ",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265058065",
            "telephone_number": "304-291-7524",
            "fax_number": "304-292-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PINECREST PLZ",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265058065",
            "telephone_number": "304-291-7524",
            "fax_number": "304-292-6391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UBC LATE STAGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-15",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "304-291-7524",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "WV",
            "license": "MO0560083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5055151",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UBC Late Stage, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joanna Louise Twist, MD
• Loraine L Tyre, M.D.
• Lori Tyree
• Laura Tyson, MS, BCBA
• Seth Tyson
• Magen Nicole Ueltschy
• Uha
• Uha Clinical Pathology
• Uha Family Medicine (Paasgrp)
• Uha Family Medicine Lab

• Mail Order Pharmacy in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Mail Order Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.