| |
106 Harold K Michaels Dr Mathias WV 26812-8142 | |
(304) 897-5915 | |
(304) 897-6216 |
Full Name | |
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Speciality | Clinic/Center |
Location | 106 Harold K Michaels Dr, Mathias, West Virginia |
Authorized Official Name and Position | Melissa Walls (CEO) |
Authorized Official Contact | 3048975915 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 97 Baker WV 26801-0097 Ph: (304) 897-5915 | 106 Harold K Michaels Dr Mathias WV 26812-8142 Ph: (304) 897-5915 |
NPI Number | 1225096027 |
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Provider Enumeration Date | 05/02/2006 |
Last Update Date | 01/29/2020 |
Medicare PECOS PAC ID | 6204728041 |
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Medicare Enrollment ID | O20101221001043 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225096027 | NPI | - | NPPES |
2099006000 | Medicaid | WV |