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55 Little Birch Rd Sutton WV 26601-9469 | |
(304) 924-6262 | |
(304) 924-5460 |
Full Name | |
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Speciality | Clinic/Center |
Location | 55 Little Birch Rd, Sutton, West Virginia |
Authorized Official Name and Position | Dora L Potasnik (CREDENTIALING COORDINATORY) |
Authorized Official Contact | 3045872541 |
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 147 Clay WV 25043-0147 Ph: (304) 587-2541 | 55 Little Birch Rd Sutton WV 26601-9469 Ph: (304) 924-6262 |
NPI Number | 1053821363 |
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Provider Enumeration Date | 10/02/2017 |
Last Update Date | 01/31/2024 |
Medicare PECOS PAC ID | 0446232987 |
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Medicare Enrollment ID | O20171116001588 |
Identifier | Type | State | Issuer |
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1053821363 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
J2 Osteopathic Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 485 Old Turnpike Rd, Sutton, WV 26601 Phone: 304-765-9500 Fax: 304-765-9502 | |
Braxton County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 617 Old Turnpike Road, Sutton, WV 26601 Phone: 304-765-2851 Fax: 304-765-2020 | |
Arturo B. Sabio M.d. Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 196 Riverview Dr, Sutton, WV 26601 Phone: 304-765-5943 Fax: 304-765-4003 |