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100 Fair St Middlebourne WV 26149-9525 | |
(304) 447-2471 | |
(304) 447-2471 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 100 Fair St, Middlebourne, West Virginia |
Authorized Official Name and Position | Brandon W Chadock (AO) |
Authorized Official Contact | 3046522611 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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314 S Wells St Sistersville WV 26175-1098 Ph: (304) 652-2611 | 100 Fair St Middlebourne WV 26149-9525 Ph: (304) 447-2471 |
NPI Number | 1538485230 |
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Provider Enumeration Date | 04/20/2010 |
Last Update Date | 10/21/2020 |
Identifier | Type | State | Issuer |
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1538485230 | NPI | - | NPPES |
3810018302 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 513413 (West Virginia) | Primary |