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150 Paducah Drive New Martinsville WV 26155-2710 | |
(304) 455-8190 | |
(304) 455-8131 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 150 Paducah Drive, New Martinsville, West Virginia |
Authorized Official Name and Position | Edwin Szewczyk (CFO) |
Authorized Official Contact | 3044558013 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 244 New Martinsville WV 26155-0244 Ph: (304) 455-8006 | 150 Paducah Drive New Martinsville WV 26155-2710 Ph: (304) 455-8190 |
NPI Number | 1225176563 |
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Provider Enumeration Date | 02/01/2007 |
Last Update Date | 07/18/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225176563 | NPI | - | NPPES |
0001221007 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |