Pineville Children's Clinic | |
Us Route 103 Supply St Gary WV 24836 | |
(304) 732-7069 | |
(304) 732-7098 |
Full Name | Pineville Children's Clinic |
---|---|
Speciality | Clinic/Center |
Location | Us Route 103 Supply St, Gary, West Virginia |
Authorized Official Name and Position | Kim Harris (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 3044482101 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Pineville Children's Clinic Po Box 507 Gary WV 24836-0507 Ph: (304) 448-2101 | Pineville Children's Clinic Us Route 103 Supply St Gary WV 24836 Ph: (304) 732-7069 |
NPI Number | 1407922891 |
---|---|
Provider Enumeration Date | 11/28/2006 |
Last Update Date | 08/03/2021 |
Medicare PECOS PAC ID | 7214820547 |
---|---|
Medicare Enrollment ID | O20081029000906 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407922891 | NPI | - | NPPES |
3810014476 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Tug River Health Association, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Us Rt 52 Main Street, Gary, WV 24836 Phone: 304-448-2101 Fax: 304-448-3217 | |
Tug River Health Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Rt 103 Supply St, Gary, WV 24836 Phone: 304-448-2101 Fax: 304-448-3217 | |
Tug River Health Association, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Rr 103 Supply Street, Gary, WV 24836 Phone: 304-448-2101 Fax: 304-448-3217 | |
Tug River Health Association, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Route 103 Supply St., Gary, WV 24836 Phone: 304-448-2101 Fax: 304-448-3217 | |
Tug River Health Association, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Route 103 Supply St., Gary, WV 24836 Phone: 304-448-2101 Fax: 304-448-3217 |