| |
Rr 4 Box 315 Philippi WV 26416-9591 | |
(304) 457-5744 | |
(304) 457-5758 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | Rr 4 Box 315, Philippi, West Virginia |
Authorized Official Name and Position | John C Forester (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 3046244655 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
686 S Pike St Ste A Shinnston WV 26431-1043 Ph: (304) 624-4655 | Rr 4 Box 315 Philippi WV 26416-9591 Ph: (304) 457-5744 |
NPI Number | 1194893859 |
---|---|
Provider Enumeration Date | 12/01/2006 |
Last Update Date | 04/10/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194893859 | NPI | - | NPPES |
0034573003 | Medicaid | WV |