| Logan Regional Primary Care - Logan | |
|
38 Hospital Dr Ste 1a Logan WV 25601-3452 | |
| (304) 831-1892 | |
| (304) 831-1477 |
| Full Name | Logan Regional Primary Care - Logan |
|---|---|
| Speciality | Clinic/Center |
| Location | 38 Hospital Dr Ste 1a, Logan, West Virginia |
| Authorized Official Name and Position | Kathy Teague (ASSISTANT VP AND SECRETARY) |
| Authorized Official Contact | 6159207646 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Regional Primary Care - Logan 38 Hospital Dr Ste 1a Logan WV 25601-3452 Ph: (304) 831-1892 | Logan Regional Primary Care - Logan 38 Hospital Dr Ste 1a Logan WV 25601-3452 Ph: (304) 831-1892 |
| NPI Number | 1558095588 |
|---|---|
| Provider Enumeration Date | 07/14/2022 |
| Last Update Date | 07/28/2022 |
| Medicare PECOS PAC ID | 9537078977 |
|---|---|
| Medicare Enrollment ID | O20220901002441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558095588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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