| Parkersburg High School Wellness Center | |
|
2101 Dudley Ave Parkersburg WV 26101-3462 | |
| (304) 917-3733 | |
| Not Available |
| Full Name | Parkersburg High School Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2101 Dudley Ave, Parkersburg, West Virginia |
| Authorized Official Name and Position | Brenda Bennett (CREDENTIALING) |
| Authorized Official Contact | 3042753301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Parkersburg High School Wellness Center Po Box 609 Elizabeth WV 26143-0609 Ph: (304) 275-3301 | Parkersburg High School Wellness Center 2101 Dudley Ave Parkersburg WV 26101-3462 Ph: (304) 917-3733 |
| NPI Number | 1811664378 |
|---|---|
| Provider Enumeration Date | 08/24/2021 |
| Last Update Date | 08/24/2021 |
| Medicare PECOS PAC ID | 7810806577 |
|---|---|
| Medicare Enrollment ID | O20220209000378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811664378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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