MSRC, LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

MSRC, LLC

Doing business as

Mountain State Recovery Center

Practice address

102 Patrick Street PLZ
Charleston, WV 25387-2444

Phone

(304) 223-3200

NPI assigned

Apr 30, 2019

Last updated

Aug 14, 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

Joshua Preston Galbraith

Title

Owner

Phone

(304) 223-3200

Specialties & licenses 1

Addresses

Other names 1

• Mountain State Recovery Center Doing business as

Tax ID family

Mountain State Recovery Center2 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.

• MSRC, LLC

  dba Mountain State Recovery Center

  • Community/Behavioral Health Agency
  • Charleston, WV
  • NPI 1194294587
  NPD tax ID

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597363200000",
    "number": "1982268405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 RIVER WALK MALL",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253031026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PATRICK STREET PLZ",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253872444",
            "telephone_number": "304-223-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257011042",
            "country_code": "US",
            "telephone_number": "304-233-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MSRC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-30",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A",
        "authorized_official_last_name": "GALBRAITH",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "PRESTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-223-3200"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain State Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain State Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brenda Sue Moyer
• Ciara Moyers
• Denny Moyers, CLINICAL COUNSELOR
• MSRC, LLC (Mountain State Recovery Center)
• MSRC, LLC (Mountain State Recovery Center)
• Ashley Mueller, PA-C
• Sarah Mujadidi
• Mustafa Mukati, NP
• Prasadarao B Mukkamala, M.D.
• Raghavendra Mulinti, MD

• Methadone Clinic in Charleston, WV
• Providers in Charleston, WV by specialty
• Methadone Clinic in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.