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180 Ferrum Mountain Rd Ferrum VA 24088-2939 | |
(540) 365-4469 | |
(540) 365-4272 |
Full Name | |
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Speciality | Clinic/Center |
Location | 180 Ferrum Mountain Rd, Ferrum, Virginia |
Authorized Official Name and Position | James Werth (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2763982292 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 9 Laurel Fork VA 24352-0009 Ph: (276) 398-2292 | 180 Ferrum Mountain Rd Ferrum VA 24088-2939 Ph: (540) 365-4469 |
NPI Number | 1053442848 |
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Provider Enumeration Date | 03/07/2007 |
Last Update Date | 01/03/2020 |
Medicare PECOS PAC ID | 6204748296 |
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Medicare Enrollment ID | O20061120000384 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053442848 | NPI | - | NPPES |
1053442848 | Medicaid | VA | |
010355125 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |