| Lively Healthcare Center | |
|
533 Hackers Creek Rd Jane Lew WV 26378-8394 | |
| (304) 884-8941 | |
| (304) 884-8943 |
| Full Name | Lively Healthcare Center |
|---|---|
| Speciality | Family Medicine |
| Location | 533 Hackers Creek Rd, Jane Lew, West Virginia |
| Authorized Official Name and Position | David D Shaffer (CEO) |
| Authorized Official Contact | 3042698000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lively Healthcare Center 230 Hospital Plz Weston WV 26452-8558 Ph: (304) 269-8000 | Lively Healthcare Center 533 Hackers Creek Rd Jane Lew WV 26378-8394 Ph: (304) 884-8941 |
| NPI Number | 1225299605 |
|---|---|
| Provider Enumeration Date | 06/19/2008 |
| Last Update Date | 06/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225299605 | NPI | - | NPPES |
| 0001417002 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 19972 (West Virginia) | Primary |
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