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725 North Pike Street Grafton WV 26354-1270 | |
(304) 265-4909 | |
(304) 265-4915 |
Full Name | |
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Speciality | Clinic/Center |
Location | 725 North Pike Street, Grafton, West Virginia |
Authorized Official Name and Position | Beverly J. Snyder (EXECUTIVE ASSISTANT/ACCESS MANAGER) |
Authorized Official Contact | 3042650312 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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25 W Bluemont St Grafton WV 26354-1242 Ph: (304) 265-0312 | 725 North Pike Street Grafton WV 26354-1270 Ph: (304) 265-4909 |
NPI Number | 1992813604 |
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Provider Enumeration Date | 08/25/2006 |
Last Update Date | 02/15/2022 |
Medicare PECOS PAC ID | 3072406438 |
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Medicare Enrollment ID | O20090507000622 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992813604 | NPI | - | NPPES |
0035347000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Preston Taylor Community Health Centers, Incorporated Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 725 North Pike Street, Grafton, WV 26354 Phone: 304-265-0312 Fax: 304-265-0314 | |
R Legacy Inv Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4706 Knottsville Rd, Grafton, WV 26354 Phone: 304-265-2874 | |