| South Charleston Primary Care | |
|
312 6th Ave Suite 3 South Charleston WV 25303-1242 | |
| (304) 744-4532 | |
| (304) 744-3219 |
| Full Name | South Charleston Primary Care |
|---|---|
| Speciality | Family Medicine |
| Location | 312 6th Ave, South Charleston, West Virginia |
| Authorized Official Name and Position | Terri Jo Coleman (OFFICE MANAGER) |
| Authorized Official Contact | 3047444532 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Charleston Primary Care 312 6th Ave Suite 3 South Charleston WV 25303-1242 Ph: (304) 744-4532 | South Charleston Primary Care 312 6th Ave Suite 3 South Charleston WV 25303-1242 Ph: (304) 744-4532 |
| NPI Number | 1689758476 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689758476 | NPI | - | NPPES |
| 0009405002 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 10611 (West Virginia) | Primary |
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