| Shenandoah Valley Medical System,inc. | |
|
44 Trifecta Pl Ste 205 Charles Town WV 25414-5720 | |
| (304) 728-3716 | |
| (304) 278-3740 |
| Full Name | Shenandoah Valley Medical System,inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 44 Trifecta Pl Ste 205, Charles Town, West Virginia |
| Authorized Official Name and Position | Michael Hassing (CEO) |
| Authorized Official Contact | 3042634999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shenandoah Valley Medical System,inc. Po Box 1146 Martinsburg WV 25402-1146 Ph: (304) 263-4999 | Shenandoah Valley Medical System,inc. 44 Trifecta Pl Ste 205 Charles Town WV 25414-5720 Ph: (304) 728-3716 |
| NPI Number | 1992904668 |
|---|---|
| Provider Enumeration Date | 07/13/2007 |
| Last Update Date | 10/23/2019 |
| Medicare PECOS PAC ID | 9739093097 |
|---|---|
| Medicare Enrollment ID | O20051229000496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992904668 | NPI | - | NPPES |
| 3810008360 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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