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186 Hospital Drive Grantsville WV 26147-7100 | |
(304) 354-9244 | |
(304) 354-9323 |
Full Name | |
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Speciality | Clinic/Center |
Location | 186 Hospital Drive, Grantsville, West Virginia |
Authorized Official Name and Position | Stephen S. Whited (CFO/COO) |
Authorized Official Contact | 3043549244 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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186 Hospital Drive Grantsville WV 26147-7100 Ph: (304) 354-9244 | 186 Hospital Drive Grantsville WV 26147-7100 Ph: (304) 354-9244 |
NPI Number | 1609983691 |
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Provider Enumeration Date | 08/24/2006 |
Last Update Date | 04/18/2012 |
Medicare PECOS PAC ID | 2961311667 |
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Medicare Enrollment ID | O20061208000464 |
Identifier | Type | State | Issuer |
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1609983691 | NPI | - | NPPES |
513998 | Other | WV | RURAL HEALTH CLINIC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 150 (West Virginia) | Primary |