| Clendenin Health Center | |
|
107 Koontz Ave. Suite 200 Clendenin WV 25045 | |
| (304) 548-4900 | |
| Not Available |
| Full Name | Clendenin Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 107 Koontz Ave., Clendenin, West Virginia |
| Authorized Official Name and Position | Craig H. Robinson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3047342040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clendenin Health Center 107 Koontz Ave. Suite 200 Clendenin WV 25045 Ph: (304) 548-4900 | Clendenin Health Center 107 Koontz Ave. Suite 200 Clendenin WV 25045 Ph: (304) 548-4900 |
| NPI Number | 1437199742 |
|---|---|
| Provider Enumeration Date | 06/07/2006 |
| Last Update Date | 06/06/2014 |
| Medicare PECOS PAC ID | 2466431101 |
|---|---|
| Medicare Enrollment ID | O20060825000140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437199742 | NPI | - | NPPES |
| 001835095 | Other | WV | MS BCBS |
| 3810005141 | Medicaid | WV | |
| 001710317 | Other | WV | MS BCBS |
| 3810006995 | Medicaid | WV | |
| 001881671 | Other | WV | MS BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 031820 (West Virginia) | Primary |
Riverview Pharmacy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Koontz Ave, Clendenin, WV 25045 Phone: 304-548-7272 Fax: 304-548-7149 | |
Clendenin Health Center Lab Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Koontz Ave Ste 200, Clendenin, WV 25045 Phone: 304-734-2040 Fax: 301-734-2047 |