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Hospital Drive Petersburg WV 26847 | |
(304) 257-2152 | |
(304) 257-2928 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | Hospital Drive, Petersburg, West Virginia |
Authorized Official Name and Position | Mary Beth Barr (CEO) |
Authorized Official Contact | 3042571026 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1019 Petersburg WV 26847-1019 Ph: (304) 257-1026 | Hospital Drive Petersburg WV 26847 Ph: (304) 257-2152 |
NPI Number | 1396744108 |
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Provider Enumeration Date | 07/14/2005 |
Last Update Date | 01/26/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396744108 | NPI | - | NPPES |
0206602000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
South Branch Hospitalist And Internal Medicine Group Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 65 Hospital Dr Ste 102, Petersburg, WV 26847 Phone: 304-257-2527 Fax: 304-257-1469 | |
Dewey F Bensenhaver Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Hc 30 Box 95, Petersburg, WV 26847 Phone: 304-257-1456 | |