Provider Demographics
NPI:1841171121
Name:WELLPOINT WEST VIRGINIA INC
Entity type:Organization
Organization Name:WELLPOINT WEST VIRGINIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-716-5186
Mailing Address - Street 1:200 ASSOCIATION DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-1278
Mailing Address - Country:US
Mailing Address - Phone:304-347-2483
Mailing Address - Fax:
Practice Address - Street 1:200 ASSOCIATION DR STE 200
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-1278
Practice Address - Country:US
Practice Address - Phone:304-347-2483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization