| Pine Grove Rural Health Clinic | |
|
12960 Shortline Hwy Pine Grove WV 26419 | |
| (304) 889-3344 | |
| (304) 889-3366 |
| Full Name | Pine Grove Rural Health Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 12960 Shortline Hwy, Pine Grove, West Virginia |
| Authorized Official Name and Position | Brian Felici (CEO) |
| Authorized Official Contact | 3044558000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Grove Rural Health Clinic P.o. Box 244 New Martinsville WV 26155-2705 Ph: (304) 455-8000 | Pine Grove Rural Health Clinic 12960 Shortline Hwy Pine Grove WV 26419 Ph: (304) 889-3344 |
| NPI Number | 1326186586 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 02/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326186586 | NPI | - | NPPES |
| 0001221008 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (West Virginia) | Primary |
Wetzel County Hospital, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12960 Shortline Hwy, Pine Grove, WV 26419 Phone: 304-889-3344 Fax: 304-889-3366 |