| |
2001 Stadium Drive, Suite D, Bluefield, WV 24701 | |
(304) 324-2954 | |
(304) 324-2955 |
Full Name | |
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Type | Facility |
Speciality | Audiologist |
Location | 2001 Stadium Drive, Bluefield, West Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598981524 | NPI | - | NPPES |
CC375 | Other | PALMETTO GBA RR MEDICARE | |
3810002482 | Medicaid | WV | |
PR9319052 | Other | MEDICARE PALMETTO GBA PTAN NUMBER |
Mailing Address | Practice Location Address |
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508 New Hope Road, Suite #19, Princeton, WV 24740-2272 Ph: (304) 487-2487 | 2001 Stadium Drive, Suite D, Bluefield, WV 24701 Ph: (304) 324-2954 |