Provider Demographics
NPI:1104346204
Name:ABSOLUTE CARE CLINIC
Entity type:Organization
Organization Name:ABSOLUTE CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:M ANWAR
Authorized Official - Middle Name:YAHYA
Authorized Official - Last Name:ABDEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-546-1768
Mailing Address - Street 1:112 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:WV
Mailing Address - Zip Code:25601-3602
Mailing Address - Country:US
Mailing Address - Phone:304-896-5025
Mailing Address - Fax:304-896-5058
Practice Address - Street 1:112 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3602
Practice Address - Country:US
Practice Address - Phone:304-896-5025
Practice Address - Fax:304-896-5058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20596261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center