Provider Demographics
NPI:1144317082
Name:WILFREDO N. MOLANO MDSC INC
Entity type:Organization
Organization Name:WILFREDO N. MOLANO MDSC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILFREDO
Authorized Official - Middle Name:NAVA
Authorized Official - Last Name:MOLANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-562-3331
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526
Mailing Address - Country:US
Mailing Address - Phone:304-562-3331
Mailing Address - Fax:304-562-3364
Practice Address - Street 1:2733 MAIN ST
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-1420
Practice Address - Country:US
Practice Address - Phone:304-562-3331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10473261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV8802214OtherMEDICARE
WV8802214OtherMEDICARE
WVB42826Medicare UPIN