| Paas Fqhc | |
|
176 Medical Center Dr Rainelle WV 25962-1064 | |
| (304) 438-6188 | |
| (304) 438-4037 |
| Full Name | Paas Fqhc |
|---|---|
| Speciality | Clinic/Center |
| Location | 176 Medical Center Dr, Rainelle, West Virginia |
| Authorized Official Name and Position | Debra J Bennett (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 3044386188 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paas Fqhc 176 Medical Center Dr Rainelle WV 25962-1064 Ph: (304) 438-6188 | Paas Fqhc 176 Medical Center Dr Rainelle WV 25962-1064 Ph: (304) 438-6188 |
| NPI Number | 1437227766 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 03/02/2023 |
| Medicare PECOS PAC ID | 7416861810 |
|---|---|
| Medicare Enrollment ID | O20040311000136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437227766 | NPI | - | NPPES |
| 0035037000 | Medicaid | WV | |
| CA6655 | Other | WV | MEDICARE RAILROAD |
| DC3636 | Other | WV | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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