Provider Demographics
NPI:1396284089
Name:EAST MOUNTAIN HEALTH PHYSICIANS INC
Entity type:Organization
Organization Name:EAST MOUNTAIN HEALTH PHYSICIANS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BECHAMPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-822-4933
Mailing Address - Street 1:220 CAMPUS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0104
Practice Address - Street 1:1179 T J JACKSON DR
Practice Address - Street 2:SUITE B
Practice Address - City:FALLING WATERS
Practice Address - State:WV
Practice Address - Zip Code:25419-4698
Practice Address - Country:US
Practice Address - Phone:304-350-3201
Practice Address - Fax:304-350-3240
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST MOUNTAIN HEALTH PHYSICIANS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-15
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care