| Fairmont Ent Associates, Inc. | |
|
300 S Price St Kingwood WV 26537-1442 | |
| (304) 366-6157 | |
| (304) 366-0177 |
| Full Name | Fairmont Ent Associates, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 300 S Price St, Kingwood, West Virginia |
| Authorized Official Name and Position | Joedy L Daristotle (PHYSICIAN) |
| Authorized Official Contact | 3043666157 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairmont Ent Associates, Inc. 1712 Locust Ave Fairmont WV 26554-1321 Ph: (304) 366-6157 | Fairmont Ent Associates, Inc. 300 S Price St Kingwood WV 26537-1442 Ph: (304) 366-6157 |
| NPI Number | 1659554046 |
|---|---|
| Provider Enumeration Date | 12/10/2007 |
| Last Update Date | 05/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659554046 | NPI | - | NPPES |
| 0041418000 | Medicaid | WV | |
| CL6325 | Other | WV | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | WV14772 (West Virginia) | Primary |
Schwarzenberg & Schwarzenberg Mds Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 N Price St, Kingwood, WV 26537 Phone: 304-329-3500 Fax: 304-329-2088 | |
Preston Family Health Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 Morgantown St, Kingwood, WV 26537 Phone: 304-329-0555 Fax: 304-329-0556 | |
Total Family Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 428 Morgantown Street, Kingwood, WV 26537 Phone: 304-329-0256 Fax: 304-329-0733 | |
Kingwood Family Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17548 Veterans Memorial Highway, Suite D, Kingwood, WV 26537 Phone: 304-441-2001 Fax: 304-441-2009 |