| Family Medical Clinic Of Jane Lew (epsdt) | |
|
134 Industrial Park Rd Jane Lew WV 26378 | |
| (304) 884-7880 | |
| Not Available |
| Full Name | Family Medical Clinic Of Jane Lew (epsdt) |
|---|---|
| Speciality | Family Medicine |
| Location | 134 Industrial Park Rd, Jane Lew, West Virginia |
| Authorized Official Name and Position | Lillie Swisher (OFFICE MANAGER) |
| Authorized Official Contact | 3048847880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Clinic Of Jane Lew (epsdt) 134 Industrial Park Rd Jane Lew WV 26378 Ph: (304) 884-7880 | Family Medical Clinic Of Jane Lew (epsdt) 134 Industrial Park Rd Jane Lew WV 26378 Ph: (304) 884-7880 |
| NPI Number | 1144308040 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144308040 | NPI | - | NPPES |
| 5500001000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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