| Glenville Office - Medicare | |
|
376 Wv Hwy 5 E Suite 101 Glenville WV 26351 | |
| (304) 462-7322 | |
| Not Available |
| Full Name | Glenville Office - Medicare |
|---|---|
| Speciality | Clinic/Center |
| Location | 376 Wv Hwy 5 E, Glenville, West Virginia |
| Authorized Official Name and Position | Stephen S. Whited (CFO/COO) |
| Authorized Official Contact | 3043549244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenville Office - Medicare 186 Hospital Drive Grantsville WV 26147-7100 Ph: (304) 354-9244 | Glenville Office - Medicare 376 Wv Hwy 5 E Suite 101 Glenville WV 26351 Ph: (304) 462-7322 |
| NPI Number | 1093828568 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 05/18/2023 |
| Medicare PECOS PAC ID | 2961311667 |
|---|---|
| Medicare Enrollment ID | O20030314000003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093828568 | NPI | - | NPPES |
| 511871 | Other | WV | GLENVILLE OFFICE - FQHC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 150 (West Virginia) | Primary |
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