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83 Poplar Street Rowlesburg WV 26425-0565 | |
(304) 454-2421 | |
(304) 454-9690 |
Full Name | |
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Speciality | Clinic/Center |
Location | 83 Poplar Street, Rowlesburg, West Virginia |
Authorized Official Name and Position | Beverly J. Snyder (EXECUTIVE ASSISTANT/ACCESS MANAGER) |
Authorized Official Contact | 3042650312 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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25 W Bluemont St Grafton WV 26354-1242 Ph: (304) 265-0312 | 83 Poplar Street Rowlesburg WV 26425-0565 Ph: (304) 454-2421 |
NPI Number | 1093729857 |
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Provider Enumeration Date | 07/28/2006 |
Last Update Date | 02/23/2022 |
Medicare PECOS PAC ID | 3072406438 |
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Medicare Enrollment ID | O20090507000636 |
Identifier | Type | State | Issuer |
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1093729857 | NPI | - | NPPES |
0035354000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |