Renal Rd Wv Llc | |
1811 Coffman St, Barboursville, WV 25504-2023 | |
(304) 617-4067 | |
Not Available |
Full Name | Renal Rd Wv Llc |
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Type | Facility |
Speciality | Dietitian, Registered |
Location | 1811 Coffman St, Barboursville, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1881276665 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Provider Name | Jillian Pate |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1245825223 PECOS PAC ID: 2062821747 Enrollment ID: I20210510001829 |
Mailing Address | Practice Location Address |
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Renal Rd Wv Llc 1811 Coffman St, Barboursville, WV 25504-2023 Ph: (304) 617-4067 | Renal Rd Wv Llc 1811 Coffman St, Barboursville, WV 25504-2023 Ph: (304) 617-4067 |
Jillian Pate, MS, RD, CSR, LD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 1811 Coffman St, Barboursville, WV 25504 Phone: 304-617-4067 | |
Pamela Michelle Harris, RD Dietitian Medicare: Medicare Enrolled Practice Location: 3 Steiner Blvd, Barboursville, WV 25504 Phone: 304-617-1769 | |
Brittany Paitsel, MS, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1811 Coffman St, Barboursville, WV 25504 Phone: 228-276-8170 |