| |
266 Skidmore Ln Sutton WV 26601-9271 | |
(394) 765-0351 | |
(304) 765-7019 |
Full Name | |
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Speciality | Clinic/Center |
Location | 266 Skidmore Ln, Sutton, West Virginia |
Authorized Official Name and Position | Dora L Potasnik (CREDENTIALING) |
Authorized Official Contact | 3043177275 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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266 Skidmore Ln Sutton WV 26601-9271 Ph: (394) 765-0351 | 266 Skidmore Ln Sutton WV 26601-9271 Ph: (394) 765-0351 |
NPI Number | 1770917577 |
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Provider Enumeration Date | 08/28/2013 |
Last Update Date | 01/19/2024 |
Medicare PECOS PAC ID | 0446232987 |
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Medicare Enrollment ID | O20131031000746 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770917577 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
J2 Osteopathic Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 485 Old Turnpike Rd, Sutton, WV 26601 Phone: 304-765-9500 Fax: 304-765-9502 | |
Braxton County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 617 Old Turnpike Road, Sutton, WV 26601 Phone: 304-765-2851 Fax: 304-765-2020 | |
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