| South Harrison Family Medicine | |
|
2324 Hawk Highway Lost Creek WV 26385-9707 | |
| (304) 745-3200 | |
| (304) 745-4068 |
| Full Name | South Harrison Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 2324 Hawk Highway, Lost Creek, West Virginia |
| Authorized Official Name and Position | Jo Ann Longenecker (PRESIDENT) |
| Authorized Official Contact | 3047453200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Harrison Family Medicine 2324 Hawk Highway Lost Creek WV 26385-9707 Ph: (304) 745-3200 | South Harrison Family Medicine 2324 Hawk Highway Lost Creek WV 26385-9707 Ph: (304) 745-3200 |
| NPI Number | 1922197573 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 12/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922197573 | NPI | - | NPPES |
| 0007163000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 15551 (West Virginia) | Primary |
South Harrison Middle School Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Rr 1 Box 58b, Lost Creek, WV 26385 Phone: 304-326-7460 Fax: 304-745-5587 | |
South Harrison High School Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Rr 1 Box 58, Lost Creek, WV 26385 Phone: 304-326-7440 Fax: 304-745-4292 |