| |
30 Grizzley Ln Summersville WV 26651-9736 | |
(304) 883-3900 | |
(304) 872-3190 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 30 Grizzley Ln, Summersville, West Virginia |
Authorized Official Name and Position | John R. Schultz (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 3044692905 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
497 Mall Rd Oak Hill WV 25901-6216 Ph: () - | 30 Grizzley Ln Summersville WV 26651-9736 Ph: (304) 883-3900 |
NPI Number | 1689669855 |
---|---|
Provider Enumeration Date | 09/14/2005 |
Last Update Date | 10/09/2023 |
Medicare PECOS PAC ID | 2365348596 |
---|---|
Medicare Enrollment ID | O20110204000703 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689669855 | NPI | - | NPPES |
0035165000 | Medicaid | WV | |
3810020406 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 1036-9138 (West Virginia) | Primary |
Camden On Gauley Medical Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 477 Scenic Hwy, Summersville, WV 26651 Phone: 304-226-5725 Fax: 304-226-3274 | |
Camden On Gauley Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 165 Country Rd, Summersville, WV 26651 Phone: 304-226-5725 Fax: 304-226-3274 | |
Fairview Health Associates Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 350 Fairview Heights Rd, Summersville, WV 26651 Phone: 304-872-5090 Fax: 304-872-0636 | |
Professional Medical Ultrasonics Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4089 Webster Rd Suite 5, Summersville, WV 26651 Phone: 304-872-8396 | |
Summersville Family Medicine Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 Merchants Walk, Shopping Center, Summersville, WV 26651 Phone: 304-645-4043 |