Clinic IV Inc

Primary specialty

Home Infusion AgencyTaxonomy code 251F00000X

License

SP0552254 Issued in WV

Legal business name

CLINIC IV INC

Practice address

100 New Hope Rd
Princeton, WV 24740-2143

Phone

(304) 425-9592

Fax

(304) 487-8967

NPI assigned

Dec 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Phillip Hurst, RPH

Title

Vice President

Phone

(304) 425-9592

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Princeton Community Hospital Assn. Inc.

  dba PCH Behavioral Health Center

  • Psychiatric Hospital Unit
  • Bluefield, WV
  • NPI 1619053329

  Member Of

  NPD member

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639235310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NEW HOPE RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402143",
            "telephone_number": "304-425-9592",
            "fax_number": "304-487-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NEW HOPE RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402143",
            "telephone_number": "304-425-9592",
            "fax_number": "304-487-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINIC IV INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HURST",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "304-425-9592",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "WV",
            "license": "SP0552254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0144276001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helen Yvonne Clarke
• Monica Katherine Clemons
• Shaun Clemons
• Andrew Cline
• Ginger Cline
• Clinic Pharmacy of Princeton Inc (Clinic Pharmacy Inc)
• Kayla Clisso
• Alexis Clower
• Candida Clower
• Lauren Clower

• Home Infusion Agency in Princeton, WV
• Providers in Princeton, WV by specialty
• Home Infusion Agency in West Virginia

• 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.