| Summersville Family Medicine Inc | |
|
211 Merchants Walk Shopping Center Summersville WV 26651-1901 | |
| (304) 645-4043 | |
| Not Available |
| Full Name | Summersville Family Medicine Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 211 Merchants Walk, Summersville, West Virginia |
| Authorized Official Name and Position | Richard S Trenbath (PRESIDENT) |
| Authorized Official Contact | 3046454043 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summersville Family Medicine Inc Po Box 1049 Lewisburg WV 24901-4049 Ph: () - | Summersville Family Medicine Inc 211 Merchants Walk Shopping Center Summersville WV 26651-1901 Ph: (304) 645-4043 |
| NPI Number | 1437426780 |
|---|---|
| Provider Enumeration Date | 11/30/2011 |
| Last Update Date | 10/10/2016 |
| Medicare PECOS PAC ID | 6103084512 |
|---|---|
| Medicare Enrollment ID | O20120214000783 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437426780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 12758 (West Virginia) | Primary |
| 207QG0300X | Family Medicine - Geriatric Medicine | 12758 (West Virginia) | Secondary |
| Provider Name | Richard S Trenbath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124002043 PECOS PAC ID: 0143244251 Enrollment ID: I20061003000042 |
| Provider Name | Donna H Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073760864 PECOS PAC ID: 0941357396 Enrollment ID: I20090422000157 |
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