| |
3208 Husky Hwy, Farmington, WV 26571-8122 | |
(304) 825-6364 | |
(304) 825-6750 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 3208 Husky Hwy, Farmington, 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 |
---|---|---|---|
1245203900 | NPI | - | NPPES |
0149303000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | WV830D (West Virginia) | Primary |
Provider Name | Caleb Tennant |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1124258009 PECOS PAC ID: 8820112279 Enrollment ID: I20100908000075 |
Provider Name | Matthew Glen Berardi |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1417022773 PECOS PAC ID: 5890808273 Enrollment ID: I20111103000318 |
Mailing Address | Practice Location Address |
---|---|
3208 Husky Hwy, Farmington, WV 26571-8122 Ph: (304) 825-6364 | 3208 Husky Hwy, Farmington, WV 26571-8122 Ph: (304) 825-6364 |
Matthew Glen Berardi, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3208 Husky Hwy, Farmington, WV 26571 Phone: 304-825-6364 Fax: 304-825-6750 | |
Westover Eye Associates Pllc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3208 Husky Hwy, Farmington, WV 26571 Phone: 304-825-6364 |