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85 Donohoe Dr Huntington WV 25705-8887 | |
| (304) 399-3310 | |
| (304) 523-5416 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 85 Donohoe Dr, Huntington, West Virginia |
| Authorized Official Name and Position | Mary-beth Brubeck (VP OF FINANCE, CFO) |
| Authorized Official Contact | 3045253334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2585 3rd Ave Huntington WV 25703-1642 Ph: (304) 525-3334 | 85 Donohoe Dr Huntington WV 25705-8887 Ph: (304) 399-3310 |
| NPI Number | 1720333461 |
|---|---|
| Provider Enumeration Date | 07/18/2012 |
| Last Update Date | 04/18/2024 |
| Certification Date | 08/18/2021 |
| Medicare PECOS PAC ID | 9931017969 |
|---|---|
| Medicare Enrollment ID | O20121129000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720333461 | NPI | - | NPPES |
| 3810025314 | Medicaid | WV | |
| 0079937 | Medicaid | OH | |
| 0078061 | Medicaid | OH | |
| 7100222210 | Medicaid | KY | |
| 7100235260 | Medicaid | KY |
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