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1301 Hal Greer Blvd Huntington WV 25701-3803 | |
| (304) 525-0572 | |
| (304) 529-1119 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1301 Hal Greer Blvd, Huntington, West Virginia |
| Authorized Official Name and Position | Mary-beth Brubeck (VICE PRESIDENT 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) 697-1396 | 1301 Hal Greer Blvd Huntington WV 25701-3803 Ph: (304) 525-0572 |
| NPI Number | 1710952056 |
|---|---|
| Provider Enumeration Date | 02/21/2006 |
| Last Update Date | 03/31/2022 |
| Certification Date | 03/31/2022 |
| Medicare PECOS PAC ID | 9931017969 |
|---|---|
| Medicare Enrollment ID | O20101217000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710952056 | NPI | - | NPPES |
| 0998658 | Medicaid | OH | |
| CJ2698 | Other | WV | RR MEDICARE GROUP |
| 7100050720 | Medicaid | KY | |
| 0035105000 | Medicaid | WV |
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