| |
356 Nicholas Street Rupert WV 25984 | |
(304) 645-3220 | |
(304) 645-4103 |
Full Name | |
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Speciality | Clinic/Center |
Location | 356 Nicholas Street, Rupert, West Virginia |
Authorized Official Name and Position | Mary P Nemcik (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 3046453220 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1464 Jefferson St N Lewisburg WV 24901-1380 Ph: (304) 645-3220 | 356 Nicholas Street Rupert WV 25984 Ph: (304) 645-3220 |
NPI Number | 1093220303 |
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Provider Enumeration Date | 12/08/2017 |
Last Update Date | 01/30/2025 |
Medicare PECOS PAC ID | 0941113427 |
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Medicare Enrollment ID | O20180214000908 |
Identifier | Type | State | Issuer |
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1093220303 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
363LF0000X | Nurse Practitioner - Family | 36604 (West Virginia) | Secondary |
Regional Family Medicine, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 406nicholas Street, Rupert, WV 25984 Phone: 304-645-4043 Fax: 304-645-4713 |