| |
651 Water St, Summersville, WV 26651-1454 | |
(304) 872-5678 | |
(304) 226-3274 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 651 Water St, Summersville, 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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1952033508 | NPI | - | NPPES |
Provider Name | Eddie Prendergast |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1134165251 PECOS PAC ID: 2668535964 Enrollment ID: I20090113000569 |
Provider Name | Alexandra Lee Horne |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1972027894 PECOS PAC ID: 2466714910 Enrollment ID: I20210930001810 |
Mailing Address | Practice Location Address |
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10003 Webster Rd, Camden On Gauley, WV 26208-7713 Ph: (304) 226-5725 | 651 Water St, Summersville, WV 26651-1454 Ph: (304) 872-5678 |