| Family Health Center Pllc | |
|
1004 Sushruta Dr Ste C Martinsburg WV 25401-8801 | |
| (304) 264-0888 | |
| (304) 264-0878 |
| Full Name | Family Health Center Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1004 Sushruta Dr Ste C, Martinsburg, West Virginia |
| Authorized Official Name and Position | Mehran Khajavi (OWNER/PHYSICIAN) |
| Authorized Official Contact | 3042640888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Center Pllc P.o. Box 4458 Leesburg VA 20177 Ph: (703) 895-2237 | Family Health Center Pllc 1004 Sushruta Dr Ste C Martinsburg WV 25401-8801 Ph: (304) 264-0888 |
| NPI Number | 1912250663 |
|---|---|
| Provider Enumeration Date | 10/18/2012 |
| Last Update Date | 02/11/2020 |
| Medicare PECOS PAC ID | 4183863905 |
|---|---|
| Medicare Enrollment ID | O20130626000578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912250663 | NPI | - | NPPES |
| 3810026141 | Medicaid | WV | |
| C487 | Other | WV | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 22758 (West Virginia) | Primary |
| Provider Name | Mehran Khajavi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013136464 PECOS PAC ID: 8527155639 Enrollment ID: I20071106000157 |
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