| Gilmer Office - Medicare - Fqhc | |
|
809 Mineral Rd Ste 1 Glenville WV 26351-1385 | |
| (304) 354-9244 | |
| (304) 354-9323 |
| Full Name | Gilmer Office - Medicare - Fqhc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 809 Mineral Rd Ste 1, Glenville, West Virginia |
| Authorized Official Name and Position | Stephen S. Whited (CEO) |
| Authorized Official Contact | 3043549244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gilmer Office - Medicare - Fqhc 186 Hospital Dr Grantsville WV 26147-7100 Ph: (304) 354-9244 | Gilmer Office - Medicare - Fqhc 809 Mineral Rd Ste 1 Glenville WV 26351-1385 Ph: (304) 354-9244 |
| NPI Number | 1740397470 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 10/30/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740397470 | NPI | - | NPPES |
| 5369001-000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 150 (West Virginia) | Primary |
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