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1321 N Mountaineer Highway Newburg WV 26410 | |
(304) 892-2812 | |
(304) 892-2814 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1321 N Mountaineer Highway, Newburg, West Virginia |
Authorized Official Name and Position | Elizabeth J Griffith (CHIEF EXECUTIVE OFFICER) |
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 | 1321 N Mountaineer Highway Newburg WV 26410 Ph: (304) 892-2812 |
NPI Number | 1154439859 |
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Provider Enumeration Date | 08/25/2006 |
Last Update Date | 12/09/2024 |
Medicare PECOS PAC ID | 3072406438 |
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Medicare Enrollment ID | O20090507000607 |
Identifier | Type | State | Issuer |
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1154439859 | NPI | - | NPPES |
0035308000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |