Renee'S Birkenstock Parkersburg, LLC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

809506 Issued in WV

Legal business name

RENEE'S BIRKENSTOCK PARKERSBURG, LLC

Practice address

1500 Grand Central Ave
Suite 106a
Vienna, WV 26105-1079

Phone

(304) 865-2315

Fax

(304) 428-6142

NPI assigned

Aug 31, 2008

Organization subpart

No

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

Authorized official

Name

Helen Louise Paxton

Title

Member

Phone

(304) 865-2315

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1220140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226880000000",
    "number": "1912155102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 GRAND CENTRAL AVE",
            "address_2": "SUITE 106A",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261051079",
            "telephone_number": "304-865-2315",
            "fax_number": "304-428-6142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 GRAND CENTRAL AVE",
            "address_2": "SUITE 106A",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261051079",
            "telephone_number": "304-865-2315",
            "fax_number": "304-428-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEE'S BIRKENSTOCK PARKERSBURG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-31",
        "last_updated": "2008-11-17",
        "status": "A",
        "authorized_official_last_name": "PAXTON",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "304-865-2315"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "WV",
            "license": "809506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-Pharmacy Dispensing Site in Vienna, WV
• Providers in Vienna, WV by specialty
• Non-Pharmacy Dispensing Site in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; 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.