| Familycare Healthcenter | |
|
116 Hills Plz Charleston WV 25387-2438 | |
| (304) 720-4466 | |
| (304) 720-4813 |
| Full Name | Familycare Healthcenter |
|---|---|
| Speciality | Clinic/Center |
| Location | 116 Hills Plz, Charleston, West Virginia |
| Authorized Official Name and Position | Julie Dianne Ray (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 3047576999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Familycare Healthcenter 97 Great Teays Blvd Suite 6 Scott Depot WV 25560-9816 Ph: (304) 757-6999 | Familycare Healthcenter 116 Hills Plz Charleston WV 25387-2438 Ph: (304) 720-4466 |
| NPI Number | 1972773224 |
|---|---|
| Provider Enumeration Date | 03/03/2008 |
| Last Update Date | 05/24/2022 |
| Medicare PECOS PAC ID | 4587568134 |
|---|---|
| Medicare Enrollment ID | O20070330000341 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972773224 | NPI | - | NPPES |
| 001710198 | Other | WV | MS BCBS |
| C15043 | Other | WV | RR MEDICARE GROUP |
| 3810011888 | Medicaid | WV | |
| 001710197 | Other | WV | MS BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Henry Derbes |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1912434978 PECOS PAC ID: 7911389622 Enrollment ID: I20230724000718 |
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