NEUROTECH, LLC (NPI# 1811451925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811451925 |
| Entity Type | Organization |
| Organization Name | NEUROTECH, LLC |
| Other Organization Name | NEUROTECH WEST VIRGINIA |
| Practice Address |
520 Grand Central Ave Unit 204-b Vienna WV 26105-2187 |
| Mailing Address |
626 W Moreland Blvd Waukesha WI 53188-2433 |
| Practice Telephone | 2628756636 |
| Practice Fax Number | 2627540897 |
| Mailing Telephone | 2628756572 |
| Mailing Fax Number | 2627540897 |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-05-23 |
| Authorized Official Name | KRISTINE LISA WILDNER (DIRECTOR OF CONTRACTING & RESEARCH) |
| Authorized Official Telephone | 2628756572 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2472E0500X |
Technician, Other Specialization: EEG |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
Ambulatory Health Care Facilities | ||
| N | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | Suppliers | ||
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| Neurotech West Virginia | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8080 Beckett Center Dr Ste 213, West Chester, OH 450695037 | 2628756616 | 2627540897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912560772 | Neurotech, LLC | Specialist/Technologist, Other | 117 Ne Trilein Dr Ste 202, Ankeny, IA 50021-2082 | 2019-04-17 |
| 1245793447 | Neurotech, LLC | Specialist/Technologist, Other | 90 Court St Ste 211b, Middletown, CT 06457-3334 | 2019-04-13 |
| 1194283341 | Neurotech, LLC | Technician, Other | 1440 Rockside Rd Ste 315, Parma, OH 44134-2749 | 2019-03-06 |
| 1194289603 | Neurotech, LLC | Technician, Other | 2120 44th St Se Ste 202, Kentwood, MI 49508-5321 | 2019-01-29 |
| 1891259065 | Neurotech, LLC | Specialist/Technologist, Other | 1691 Town Center St, Aurora, IL 60504-4590 | 2019-01-22 |
| 1265903710 | Neurotech, LLC | Technician, Other | 2255 W Laskey Rd Ste A-2, Toledo, OH 43613-3573 | 2018-12-10 |
| 1447735451 | Neurotech, LLC | Specialist/Technologist, Other | 1820 Ridge Rd Ste 303a, Homewood, IL 60430-1759 | 2018-09-26 |
| 1942795190 | Neurotech, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1263 Main St Ste 213, Green Bay, WI 54302-1341 | 2018-06-28 |
| 1649763756 | Neurotech, LLC | Specialist/Technologist, Other | 1691 Town Center St Ste 105, Aurora, IL 60504-4589 | 2018-06-13 |
| 1679064638 | Neurotech, LLC | Clinic/Center | 4609 Mill Branch Ln, Knoxville, TN 37938-3260 | 2018-05-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Neurotech, LLC | 626 W. Moreland Blvd, Waukesha, WI 53188 |
| System for Award Management (SAM) Entities | NEUROTECH, LLC | 626 W Moreland Blvd, Waukesha, WI 53188-2433 |
| Washington State Corporations | NEUROTECH, LLC | 2510 N Pines Rd, Suite 5, Spokane Vly, WA 99206-7636 |
| Street Address |
520 GRAND CENTRAL AVE UNIT 204-B |
| City | VIENNA |
| State | WV |
| Zip Code | 26105-2187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023536596 | Medexpress Urgent Care, PC - Virginia | Emergency Medicine | 3 Merrywood Lane, Vienna, WV 26105 | 2017-09-06 |
| 1558889196 | Medexpress Urgent Care, PC - Virginia | Emergency Medicine | 2 Merrywood Lane, Vienna, WV 26105 | 2017-09-05 |
| 1538555206 | Cecilia Velarde Harrington | Internal Medicine | 418 Grand Park Dr Ste 311, Parkersburg, WV 26105 | 2015-04-09 |
| 1568854974 | Kathryn Eileen Epkey | Student in an Organized Health Care Education/Training Program | 411 28th Street, Vienna, WV 26105 | 2015-02-21 |
| 1023120441 | Robert William Azar | Otolaryngology | 1801 Grand Central Ave, Vienna, WV 26105 | 2006-08-31 |
| 1578521407 | John A Stavrakis | Optometrist | 701 Grand Central Ave, Vienna, WV 26105 | 2006-05-02 |
| 1881203149 | Charlene Rein | Dentist | 501 Grand Central Ave, Vienna, WV 26105 | 2020-07-23 |
| 1891355434 | Mohamed Moustafa Meky | Dentist | 501 Grand Central Ave, Parkersburg, WV 26105 | 2019-06-17 |
| 1710469606 | Karen Malee Palmateer | Physician Assistant | 800 Grand Central Mall, Mov Medical Office Building, Suite 10, Vienna, WV 26105 | 2018-09-06 |
| 1568990091 | Jonathon Ray Barbosa Scott | Specialist/Technologist | 1 Campus Drive, Vienna, WV 26105 | 2017-05-29 |
| Find all providers in zip 26105 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093991564 | Cardiac Imaging Center, Pllc. | Physiological Laboratory | 331 Laidley St, Suite 402, Charleston, WV 25301-1619 | 2008-01-15 |
| 1164400420 | Laboratory Corporation of America Holdings | Physiological Laboratory | 501 Locust Ave, Fairmont, WV 26554-4719 | 2006-01-06 |
Please comment or provide details below to improve the information on NEUROTECH, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.