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37456 Coal River Rd Whitesville WV 25209-9077 | |
(304) 845-1323 | |
(304) 854-1031 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 37456 Coal River Rd, Whitesville, West Virginia |
Authorized Official Name and Position | Margaret L Martin (ADMINISTRAR) |
Authorized Official Contact | 3048541323 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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37456 Coal River Rd Whitesville WV 25209-9077 Ph: (304) 845-1323 | 37456 Coal River Rd Whitesville WV 25209-9077 Ph: (304) 845-1323 |
NPI Number | 1467512152 |
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Provider Enumeration Date | 12/11/2006 |
Last Update Date | 06/19/2013 |
Identifier | Type | State | Issuer |
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1467512152 | NPI | - | NPPES |
0011696001 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |