| Activate Healthcare - Teamsters 175 & 505 Clinic | |
|
428 Division St Suite 2 South Charleston WV 25309-1469 | |
| (304) 768-0321 | |
| (304) 768-0322 |
| Full Name | Activate Healthcare - Teamsters 175 & 505 Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 428 Division St, South Charleston, West Virginia |
| Authorized Official Name and Position | Debra Geihsler (PRINCIPAL) |
| Authorized Official Contact | 7736973144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Activate Healthcare - Teamsters 175 & 505 Clinic 2010 N Damen Ave Suite F Chicago IL 60647-3284 Ph: (773) 697-3144 | Activate Healthcare - Teamsters 175 & 505 Clinic 428 Division St Suite 2 South Charleston WV 25309-1469 Ph: (304) 768-0321 |
| NPI Number | 1578922878 |
|---|---|
| Provider Enumeration Date | 02/15/2016 |
| Last Update Date | 02/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578922878 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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