| Eastridge Health Systems | |
|
235 S Water St Martinsburg WV 25401-4241 | |
| (304) 263-8954 | |
| (304) 263-8141 |
| Full Name | Eastridge Health Systems |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 235 S Water St, Martinsburg, West Virginia |
| Authorized Official Name and Position | Rita Quinn (CEO/PRESIDENT) |
| Authorized Official Contact | 3042638954 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastridge Health Systems 235 S Water St Martinsburg WV 25401-4241 Ph: (304) 263-8954 | Eastridge Health Systems 235 S Water St Martinsburg WV 25401-4241 Ph: (304) 263-8954 |
| NPI Number | 1427197748 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 09/19/2024 |
| Certification Date | 09/19/2024 |
| Medicare PECOS PAC ID | 3375532633 |
|---|---|
| Medicare Enrollment ID | O20040511000813 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427197748 | NPI | - | NPPES |
| 3810022072 | Medicaid | WV | |
| 0023817001 | Medicaid | WV | |
| 3810012620 | Medicaid | WV | |
| 0023817000 | Medicaid | WV | |
| 0023717002 | Medicaid | WV | |
| 3810022967 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 363 (West Virginia) | Primary |
| Provider Name | Ali Asghar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164494571 PECOS PAC ID: 6901805209 Enrollment ID: I20061214000424 |
| Provider Name | Jafar T Almashat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881733384 PECOS PAC ID: 2264530963 Enrollment ID: I20070604000490 |
| Provider Name | Richard James Stoltz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366616567 PECOS PAC ID: 1658537766 Enrollment ID: I20120718000049 |
| Provider Name | Kathy L Baldwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174775563 PECOS PAC ID: 9830345362 Enrollment ID: I20120815000664 |
| Provider Name | Tayyab I Paracha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629211008 PECOS PAC ID: 7810147949 Enrollment ID: I20130821000898 |
| Provider Name | Fezan H Rizvi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790813830 PECOS PAC ID: 3274794193 Enrollment ID: I20151103002956 |
| Provider Name | Amy C Kidrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780099408 PECOS PAC ID: 3375809700 Enrollment ID: I20171117000478 |
| Provider Name | Christine E Oakley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720476054 PECOS PAC ID: 0941565030 Enrollment ID: I20180518001898 |
| Provider Name | Wendy L Fitzgerald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508415910 PECOS PAC ID: 0446682686 Enrollment ID: I20191108002831 |
| Provider Name | Abdul Hameed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750395331 PECOS PAC ID: 1052729761 Enrollment ID: I20210419001922 |
| Provider Name | Joseph C Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861067142 PECOS PAC ID: 9335516681 Enrollment ID: I20221031001215 |
| Provider Name | Deana L Sassaman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134847619 PECOS PAC ID: 1557738606 Enrollment ID: I20221103000407 |
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