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288 N Hill Rd Sutton WV 26601-1225 | |
(304) 924-6262 | |
(304) 924-5460 |
Full Name | |
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Speciality | Clinic/Center |
Location | 288 N Hill Rd, Sutton, West Virginia |
Authorized Official Name and Position | Dora L Potasnik (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 3045872541 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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288 N Hill Rd Sutton WV 26601-1225 Ph: (304) 924-6262 | 288 N Hill Rd Sutton WV 26601-1225 Ph: (304) 924-6262 |
NPI Number | 1750892188 |
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Provider Enumeration Date | 10/12/2017 |
Last Update Date | 10/12/2017 |
Medicare PECOS PAC ID | 0446232987 |
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Medicare Enrollment ID | O20180111002647 |
Identifier | Type | State | Issuer |
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1750892188 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
J2 Osteopathic Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 485 Old Turnpike Rd, Sutton, WV 26601 Phone: 304-765-9500 Fax: 304-765-9502 | |
Braxton County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 617 Old Turnpike Road, Sutton, WV 26601 Phone: 304-765-2851 Fax: 304-765-2020 | |
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