| Robert C. Byrd Clinic - Rupert | |
|
356 Nicholas Street Rupert WV 25984 | |
| (304) 645-3220 | |
| (304) 645-4103 |
| Full Name | Robert C. Byrd Clinic - Rupert |
|---|---|
| Speciality | Clinic/Center |
| Location | 356 Nicholas Street, Rupert, West Virginia |
| Authorized Official Name and Position | Scot Mitchell (CEO) |
| Authorized Official Contact | 3046471211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert C. Byrd Clinic - Rupert 1464 Jefferson St N Lewisburg WV 24901-1380 Ph: (304) 645-3220 | Robert C. Byrd Clinic - Rupert 356 Nicholas Street Rupert WV 25984 Ph: (304) 645-3220 |
| NPI Number | 1093220303 |
|---|---|
| Provider Enumeration Date | 12/08/2017 |
| Last Update Date | 05/13/2021 |
| Medicare PECOS PAC ID | 0941113427 |
|---|---|
| Medicare Enrollment ID | O20180214000908 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093220303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | 36604 (West Virginia) | Secondary |
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