Ebenezer Medical Outreach Inc

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

CC0559059 Issued in WV

Legal business name

EBENEZER MEDICAL OUTREACH INC

Doing business as

Ebenezer Medical Outreach, INC

Practice address

1448 10TH Ave
Huntington, WV 25701-3581

Phone

(304) 529-0753

Fax

(304) 529-0591

NPI assigned

Sep 11, 2013

Organization subpart

No

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

Authorized official

Name

Gina Finley

Title

Pic

Phone

(304) 529-0753

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ebenezer Medical Outreach, INC Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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

• Chyrl Kay Budd, RN, C-FNP

  • Family Nurse Practitioner
  • Huntington, WV
  • NPI 1245430917
  NPD (past)
• Laura Grace Darby, RN,C-FNP

  • Family Nurse Practitioner
  • Huntington, WV
  • NPI 1235329137
  NPD (past)
• Anita Kay Swartzwelder, FNP-BC

  • Family Nurse Practitioner
  • Huntington, WV
  • NPI 1730514142
  NPD (past)
• Ella Thaxton, RDH, CTTS

  • Dental Hygienist
  • Huntington, WV
  • NPI 1477237337
  NPD (past)

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383696000000",
    "number": "1558796326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 10TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013581",
            "telephone_number": "304-529-0753",
            "fax_number": "304-529-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 10TH AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013581",
            "telephone_number": "304-529-0753",
            "fax_number": "304-529-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBENEZER MEDICAL OUTREACH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-11",
        "last_updated": "2013-11-06",
        "status": "A",
        "authorized_official_last_name": "FINLEY",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "304-529-0753"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "WV",
            "license": "CC0559059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142452",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ebenezer Medical Outreach, INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christie A Eastman, LPC
• Joshua Hunter Eastman
• John Anthony Eastone, MD
• Breanna Renee Eaves
• Patricia Lynn Eaves
• Echo Speech Therapy LLC
• Caroline Eckels
• Elizabeth Edah, MD
• Mazin Edan
• Stephanie Eddy, FNP-BC

• Clinic Pharmacy in Huntington, WV
• Providers in Huntington, WV by specialty
• Clinic Pharmacy in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.