| Ishimaru Medical Services Llc | |
|
507 Carolina Ave Chester WV 26034-1319 | |
| (304) 224-3583 | |
| (304) 459-5050 |
| Full Name | Ishimaru Medical Services Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 507 Carolina Ave, Chester, West Virginia |
| Authorized Official Name and Position | Richard Jack Diamond (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7248515312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ishimaru Medical Services Llc 507 Carolina Ave Chester WV 26034-1319 Ph: (304) 224-3583 | Ishimaru Medical Services Llc 507 Carolina Ave Chester WV 26034-1319 Ph: (304) 224-3583 |
| NPI Number | 1487399887 |
|---|---|
| Provider Enumeration Date | 04/29/2022 |
| Last Update Date | 09/28/2022 |
| Medicare PECOS PAC ID | 4082084934 |
|---|---|
| Medicare Enrollment ID | O20230110002236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487399887 | NPI | - | NPPES |
| 1700353539 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Richard Diamond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700353539 PECOS PAC ID: 1355686510 Enrollment ID: I20230110002324 |
C A Cahall Md, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 Fox Ln, Chester, WV 26034 Phone: 304-387-3344 Fax: 304-387-3006 | |
Christopher J. Kubicki, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 First Ave, Chester, WV 26034 Phone: 304-387-2761 |