Eastridge Health Systems, Inc. | |
235 S Water St Martinsburg WV 25401-4241 | |
(304) 263-8954 | |
(304) 264-0763 |
Full Name | Eastridge Health Systems, Inc. |
---|---|
Speciality | Community/behavioral Health |
Location | 235 S Water St, Martinsburg, West Virginia |
Authorized Official Name and Position | G Paul Macom (PRESIDENT/ CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 3042638954 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Eastridge Health Systems, Inc. 235 S Water St Martinsburg WV 25401-4241 Ph: (304) 263-8954 | Eastridge Health Systems, Inc. 235 S Water St Martinsburg WV 25401-4241 Ph: (304) 263-8954 |
NPI Number | 1982974416 |
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Provider Enumeration Date | 12/30/2011 |
Last Update Date | 09/19/2024 |
Certification Date | 09/19/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982974416 | NPI | - | NPPES |
0023817000 | Medicaid | WV | |
0023817001 | Medicaid | WV | |
0023817002 | Medicaid | WV | |
3810012620 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 1022-6441 (West Virginia) | Primary |
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