| Shenandoah Valley Medical System, Inc. | |
|
250 East Rd Martinsburg WV 25404-4910 | |
| (304) 263-4999 | |
| Not Available |
| Full Name | Shenandoah Valley Medical System, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 250 East Rd, Martinsburg, 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. 250 East Rd Martinsburg WV 25404-4910 Ph: (304) 263-4999 |
| NPI Number | 1508437336 |
|---|---|
| Provider Enumeration Date | 07/02/2021 |
| Last Update Date | 07/02/2021 |
| Medicare PECOS PAC ID | 9739093097 |
|---|---|
| Medicare Enrollment ID | O20210920000165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508437336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Heather Anne Eckenrode |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881971588 PECOS PAC ID: 6406095371 Enrollment ID: I20130625000798 |
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