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1 N Marion Dr Farmington WV 26571-9717 | |
(304) 366-0700 | |
(304) 366-9529 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1 N Marion Dr, Farmington, West Virginia |
Authorized Official Name and Position | Nancy L Vandergrift (PRESIDENT) |
Authorized Official Contact | 3043660700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1322 Locust Ave Po Box 1112 Fairmont WV 26554-1436 Ph: (304) 366-0700 | 1 N Marion Dr Farmington WV 26571-9717 Ph: (304) 366-0700 |
NPI Number | 1598868143 |
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Provider Enumeration Date | 09/07/2006 |
Last Update Date | 03/22/2022 |
Medicare PECOS PAC ID | 6800991977 |
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Medicare Enrollment ID | O20160518000824 |
Identifier | Type | State | Issuer |
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1598868143 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |